[Tractional diverticulum of the urinary bladder as a component in recurring inguinal hernias]

The tractonal diverticulum as contained in recidivating inguional hernia occur rather often. They are created most often during plastic surgical treatment most frequently in inguinal hernia repairs in which a suture partially or completely passes through the urinary bladder and fixes it to the layers of inguinal canal when it is being sutured. They also occur when the bladder is accidentally pinched while the sutures are being pulled taught. The diverticulum so created almost never yields characteristic symptoms, and for this reason it is most often diagnosed intraoperatively. Because of this, the surgeon must keep in mind the possible existence of such a diverticulum when reoperating a recidivating hernia localized in the lower abdomen especially those near the bladder. It is important that such a diverticulum be carefully dissected and that the bladder be adequately closed with a layers of catgut sutures. An accidental -- overlooked lesion of the urinary bladder during operation can have a fatal outcome. For this reason such lesions must never be overlooked, and should be resolved during the hernioplasty itself.