Urinary bladder inguinal hernia: an uncommon cause of scrotal swelling.

Hong Kong Med J ⎥ Volume 20 Number 4 ⎥ August 2014 ⎥ www.hkmj.org A 77-year-old man with benign prostate hypertrophy (BPH) presented to our hospital in October 2011 with a history of right groin swelling for several months. He was otherwise asymptomatic. Physical examination revealed a reducible right inguinal hernia. Ultrasound (USG) examination of the groins showed a fluid-filled lesion within the right scrotum. It had a beaked appearance at its cranial portion, which could be traced entering the right inguinal canal (Fig 1a). A tiny calcified focus was noted within this fluid-filled structure (Fig 1b). The normal right testis was displaced inferiorly (Fig 1c). Findings were suggestive of urinary bladder inguinal hernia with a bladder stone within. It was confirmed with noncontrast computed tomography (CT) of the abdomen and pelvis, which showed herniation of the urinary bladder along the inguinal canal and into the right scrotum, with a small bladder stone within (Fig 2). Urinary bladder herniation is an uncommon condition, encountered in 1% to 4% of inguinal hernias. However, over the age of 50 years, the frequency increases to about 10%.1 Most patients