Ignacio-Morales CV, Aragón-Tovar AR, Torres-Medina E, Muñoz-Islas EI, Vilchis-Cárdenas MA

Language: Spanish
References: 6
Page: 293-295
PDF size: 612.76 Kb.

ABSTRACT

Vesical hernia, an entity that is frequently associated with inguinal hernia, presents in 1-3% of cases and up to 10% of cases in men from 50-70 years of age. The majority of vesical hernias are small and their most common physiopathology is obstruction, with prostatic hyperplasia in first place. Clinical symptoms are non-specific in relation to associated obstructive pathology. Diagnosis is usually intraoperative with risk of injury. Therefore screening is recommended in men over 50 years of age with obstructive urinary symptoms associated with abdominal wall hernias. The case of a 63-year old man with vesical hernia is presented here. Patient presented with right inguinoscrotal mass related to obstructive urinary symptomatology such as micturition caliber reduction, nicturia (micturating 3-4 times), and urinary frequency (micturating up to 10 times). Patient had medical history of occasional smoking and alcohol intake, and 4-year progression of both high blood pressure and diabetes. Physical examination revealed right indirect, reducible inguinal hernia with no vascular impairment. Digital rectal examination found 40-50 g adenomatous prostate with no suspicion of malignancy. Diagnosis was made with retrograde urethrocystography and ultrasound. Anteroposterior and oblique views revealed vesical hernia of approximately 30% volume in right inguinal canal. Post-micturition film showed a reduction in size but incomplete emptying, with residual urine. Prostate specific antigen was 2.53ng/mL.

REFERENCES

1. Kate HK, Sweeney BS, Fink AS, et al. Inguinoescrotal blabber hernias: report of a series and review of literature. Can Urol Assoc J 2008;2:619-23.

2. Navarro MP, Alvarado RD, Blanco DA, Jiménez GC, Artiles HJL, Chesa PN. Uropatía obstructiva bilateral secundaria a hernia vesical masiva. Actas Urol Esp 2008:32:348-350.

3. Herranz FLM, Jiménez GM, Arellano GR, Pereira SI. Uropatía bilateral secundaria a hernia vesical inguinoescrotal. Actas Urol Esp 2002;26:306-309.

4. Herrero RS, Molinero CM, García SJ. Diagnostico ecográfico de herniación masiva de la vejiga a nivel inguinoescrotal: a propósito de un caso. Actas Urol Esp 2000;24:825-828.

5. Vásquez RM, Roca SA, Ramírez CF, et al. Hernia inguinoescrotal gigante. Actas Urol Esp 1999;23:814-817.

6. Bacigalupo LE, Bertolotto M, Barbiera F, et al. Imaging of urinary bladder hernias. AJR 2005;184:546-551.