Effects of inguinal hernias upon the bladder and ureters

The presence of inguinal hernia may be associated with extrinsic defects upon the bladder and ureter in the absence of actual herniation of the urinary structures. The findings are characteristic unless associated with irregularity of the bladder wall or elevation of the bladder floor by prostatic enlargement. In some cases, the possibility of intrinsic bladder pathology is raised, requiring retrograde study for clarification. Ureteral displacements may be either ipsilateral or contralateral, depending upon the segment of bowel involved and the side of the hernia. The bladder findings are best demonstrated when the patient is prone or upright.