From the Research
The hernia involving both the small bowel and urinary bladder is called a sliding inguinal hernia with bladder component, which occurs when the urinary bladder and small intestine protrude through a weakness in the inguinal canal. This type of hernia is more common in older males and those with increased intra-abdominal pressure from conditions like obesity, chronic cough, or prostate enlargement 1. The bladder involvement happens because the bladder is partially extraperitoneal and can slide along with the peritoneum into the hernia defect.
Key Characteristics
- The bladder can be partially or completely involved in the hernia sac, with the small bowel typically occupying the anterior portion of the hernia 2.
- These hernias often present with both gastrointestinal and urinary symptoms, including difficulty urinating, frequent urination, or the need to compress the scrotum to complete urination 3.
- Surgical repair is typically required, with careful attention to avoid bladder injury during the procedure 4.
Diagnosis and Treatment
- Diagnosis may be challenging as patients are often asymptomatic or have nonspecific symptoms, but preoperative diagnosis based on history, physical, and radiologic imaging allows for careful surgical planning and prevention of severe complications including bladder injury and leakage 1.
- The method of repair should be individualized, taking into account the diagnostic findings, and open surgical technique is often preferred over laparoscopic 2, 3.
- Possible urinary tract damage during surgery should be recognized and resolved, and a urologist should be consulted to exclude urological pathology in cases where inguinal bladder is found inside the hernia sac 3.