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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Bladder hernia complicated with cystolithiasis and bladder tumor: Two cases' analysis.

Khaled Ben Ahmed1, Khaireddine Bouassida1, Kamel Ktari2

  • 1Department of Urology, Sahloul University Hospital, Sousse, Tunisia.

Urology Annals
|October 26, 2019
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Bladder herniation during inguinal hernia repair is rare but can lead to complications like bladder stones and tumors. Accurate diagnosis using clinical and radiological findings is crucial to prevent surgical injury.

Keywords:
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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Inguinal hernia repair is a common surgical procedure, with over 20 million performed annually.
  • Bladder herniation through the inguinal canal occurs in 1%-3% of cases, potentially causing symptoms like 'two-stage micturition'.
  • Undiagnosed bladder hernias pose a risk of accidental surgical injury during routine inguinal hernia repair.

Observation:

  • Two cases of bladder herniation complicating inguinal hernia repair are presented.
  • Both patients exhibited cystolithiasis (bladder stones) secondary to the herniation.
  • One patient was also diagnosed with bladder cancer (urothelial carcinoma).

Findings:

  • Bladder herniation can present with subtle or unspecific symptoms, delaying diagnosis.
  • The presence of cystolithiasis can be an indicator of bladder herniation.
  • Bladder tumors may be incidentally discovered in patients with herniated bladders.

Implications:

  • Emphasizes the need for thorough pre-operative assessment, including imaging, to identify potential bladder involvement.
  • Highlights the importance of surgical vigilance to avoid iatrogenic injury to the bladder during inguinal hernia repair.
  • Suggests that bladder herniation may be associated with an increased risk of bladder pathology, including malignancy.