Incisional hernia of the urinary bladder following internal hemipelvectomy

Hemipelvectomies are uncommon operations, usually performed for primary or metastatic malignant disease and less frequently for benign-aggressive tumours. There are very few reports in literature regarding complications of these procedures and even fewer reports about post hemipelvectomy hernias in particular.

We present the only reported case of an incisional hernia of the urinary bladder following internal hemipelvectomy for aneurysmal bone cyst of the pubic bone. A careful literature review is also performed.

The development of the incisional hernia in the case of our patient can most likely be explained by the absence of advanced malignant disease of the pelvis that not only reduces the life expectancy but also overshadows other complications post hemipelvectomy. Furthermore, her young age and level of fitness allowed for a full postoperative rehabilitation which, combined with the proven anatomical changes of the internal organs following hemipelvectomies and the weakening of the tissues around the operative site, predisposed to the hernia formation.

Hemipelvectomies are extensive, anatomically disruptive operations, with significant detriment to the psychosomatic well being of the patients. We presented the only reported case of incisional hernia of the urinary bladder following internal hemipelvectomy and our reconstructive method of choice. We believe that, in the case of our patient, if a mesh had been used to reconstruct the primary defect during the initial surgery, this complication could have been prevented.