Abstract

Herniation of the urinary bladder into the scrotum is a highly uncommon observation. It constitutes 1–3% of all inguinal hernias^1,2. Such hernias are termed as scrotal cystocele may be asymptomatic or may present with voiding problems such as painful voiding or double stroke voiding, or manipulated voiding, inguinal or scrotal swelling and dysuria. Emptying of a scrotal cystocele with voiding is an important diagnostic feature in a patient with incarcerated bladder diverticula but it is usually diagnosed during surgery or as a result of intra-operative bladder injury. Early diagnosis with radiological imaging is important to prevent complications during surgery. Intravenous pyelography, retrograde cystography, pelvic ultrasound, computed tomography and magnetic resonance imaging can be used for preoperative diagnosis. We report a case of scrotal cystocele in a patient who presented to our hospital with acute retention of urine, irreducible inguino-scrotal swelling and lower urinary tract symptoms who was found to have bladder herniation in to the scrotum by computerized tomography (CT) of the Kidney, Ureter and Bladder(KUB) region and a diagnosis of scrotal cystocele was made. On further evaluation he was found to have post obstructive renal failure with uremic encephalopathy due to bladder herniation which is a rare presentation of inguinal bladder hernia.

Keywords: Bladder herniation, scrotal cystocele, post obstructive renal failure, uremic encephalopathy.

Dr Yuvaraj M

Assistant Professor, Department of Radiodiagnosis And Imaging

Saveetha Medical College and Hospital, Saveetha Nagar, Thandalam, Chennai - 602105