Irreducible Inguinal Bladder Herniation Containing an Intravesical Calculus: A Rare Dual Pathology.

Abstract

Inguinal bladder herniation is a rare clinical condition, and its association with a vesical calculus within the herniated bladder segment is exceptionally uncommon. We report the case of a 68-year-old man who presented with bilateral inguinal herniae accompanied by hematuria. He was evaluated with urine culture and sensitivity testing, blood investigations, and computed tomography (CT). CT imaging demonstrated a left inguinal hernia containing a portion of the urinary bladder with an associated 2.5 × 1.8 cm vesical calculus. In collaboration with the urology team, the patient underwent bilateral open mesh hernioplasty with vesicolitholapaxy using a holmium:YAG (Ho:YAG) laser. Successful reduction of the herniated bladder segment and complete removal of the calculus were achieved. Early preoperative identification of bladder herniation with an associated stone through imaging played a critical role in surgical planning and helped avoid inadvertent bladder injury during surgery. This case underscores the importance of considering bladder herniation in elderly male patients presenting with inguinal herniae and urinary symptoms, as timely diagnosis and coordinated surgical-urological management can optimize outcomes and reduce perioperative risk.