Muscle-invasive urothelial carcinoma of the bladder in a direct inguinal hernia

A man in his late 60s presented with macroscopic haematuria and a lump in the right groin that partially resolved post micturition. Clinical examination confirmed an incarcerated right inguinal hernia while imaging showed a right inguinal hernia containing part of the dome of the bladder. At cystoscopy, three papillary tumours were seen in the part of the bladder within the hernia, with the remainder of the bladder found to be normal. The patient was managed with an open right inguinal hernia repair and partial cystectomy with pelvic node dissection. Inguinal hernias containing part of the bladder are uncommon and neoplastic change in such herniated bladder is rare. We present this case to show that the management of such patients requires individualised treatment.