Massive inguino-scrotal bladder hernia

Introduction: Although inguinal hernia is common in the general population, the bladder involvement within the hernial sac is rare, and its incidence varies between 0.5 and 3 %. The aim of this study is to report a case of inguino-scrotal hernia with bladder content and to review the relevant literature. Case report: A 69-year-old male patient was clinically assessed for a left inguinoscrotal mass and spontaneous urination of the intra-abdominal portion of the bladder with the need for manual suprapubic pressure of the hernia and scrotal elevation to complete the bladder emptying (Mery's sign). Surgery revealed a direct Gilbert type IV inguinal floor defect, with a significant bladder segment protrusion across the floor of the inguinal canal. The defect was successfully repaired in a conventional way with a Lichtenstein technique employing heavy polypropylene mesh. Conclusion: A rare entity that generally constitutes an intraoperative finding when we do not have previous imaging studies, and that is resolved with a conventional hernioplasty using prosthetic material.