Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention

Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000)). It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently,...

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Main Authors: Amit Frenkel, Aviel Roy-Shapira, Ilan Shelef, Gadi Shaked, Evgeni Brotfain, Leonid Koyfman, Abraham Borer, Moti Klein
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2015/531021
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author Amit Frenkel
Aviel Roy-Shapira
Ilan Shelef
Gadi Shaked
Evgeni Brotfain
Leonid Koyfman
Abraham Borer
Moti Klein
author_facet Amit Frenkel
Aviel Roy-Shapira
Ilan Shelef
Gadi Shaked
Evgeni Brotfain
Leonid Koyfman
Abraham Borer
Moti Klein
author_sort Amit Frenkel
collection DOAJ
description Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000)). It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA) (Etanercept) for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observed in the next two years of follow-up. In this case, the primary illness and its treatment were distracting barriers to early diagnosis and treatment. In younger patients with a large hernia who develop unexpected urinary retention, herniation of the urinary bladder should be highly considered in the differential diagnosis.
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spelling doaj-art-450a0e2977d6493fb329ced6b458470c2025-08-20T03:36:44ZengWileyCase Reports in Surgery2090-69002090-69192015-01-01201510.1155/2015/531021531021Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary RetentionAmit Frenkel0Aviel Roy-Shapira1Ilan Shelef2Gadi Shaked3Evgeni Brotfain4Leonid Koyfman5Abraham Borer6Moti Klein7General Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelGeneral Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelDepartment of Radiology, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelDepartment of General Surgery, Trauma Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelGeneral Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelGeneral Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelInfection Control and Hospital Epidemiology Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelGeneral Intensive Care Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, 84101 Beer-Sheva, IsraelHerniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000)). It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA) (Etanercept) for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observed in the next two years of follow-up. In this case, the primary illness and its treatment were distracting barriers to early diagnosis and treatment. In younger patients with a large hernia who develop unexpected urinary retention, herniation of the urinary bladder should be highly considered in the differential diagnosis.http://dx.doi.org/10.1155/2015/531021
spellingShingle Amit Frenkel
Aviel Roy-Shapira
Ilan Shelef
Gadi Shaked
Evgeni Brotfain
Leonid Koyfman
Abraham Borer
Moti Klein
Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention
Case Reports in Surgery
title Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention
title_full Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention
title_fullStr Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention
title_full_unstemmed Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention
title_short Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention
title_sort inguinal herniation of the urinary bladder presenting as recurrent urinary retention
url http://dx.doi.org/10.1155/2015/531021
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