Upper and lower urinary tract obstruction secondary to inguinoscrotal hernia containing bladder and prostate gland

Inguinal hernia is a common clinical presentation, with 1-3% containing some of the urinary bladder. Most cases are asymptomatic and diagnosed intraoperatively at hernia repair. We describe a case of an 84-year-old man presenting with acute urinary retention in a bladder had herniated entirely into his scrotum. He was managed conservatively with urinary catheterisation and discharged home. He re-presented with urosepsis secondary to bilateral ureteric obstruction. This was treated with antibiotics and nephrostomy and his hernia was ultimately repaired. Clinicians should consider both upper and lower urinary tract obstruction in patients with significant bladder herniation.