Asian Journal of Case Reports in Surgery

Aims: Inguinal bladder hernia, accounting for 1-4% of inguinal hernias, is primarily diagnosed intraoperatively, with only 7% identified preoperatively. Diagnosis is challenging due to often asymptomatic or nonspecific symptoms. Standard treatment involves surgical repair, either open or laparoscopic, necessitating meticulous planning to prevent complications, including bladder injury.

Presentation of case: A 56-year-old man presented with left inguinal swelling, reducible post-voiding. Physical examination revealed a 7x5 cm irreducible left inguinal swelling with mild tenderness and urinary urgency. Ultrasonography confirmed inguinal bladder hernia, leading to open surgical reduction and mesh closure without postoperative complications.

Discussion: Inguinal bladder hernia predominantly affects older, obese males, necessitating a high index of suspicion during evaluation for inguinal hernia. Preoperative diagnosis via history, physical examination, and radiological imaging facilitates careful surgical planning, minimizing risks of complications.

Conclusion: Clinicians should remain vigilant for inguinal bladder hernia in elderly obese males with inguinal hernia, particularly those presenting with recent lower urinary tract symptoms. Early recognition and appropriate management are crucial for optimizing patient outcomes.