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Ureterosciatic hernias are extremely rare, with fewer than 40 cases reported in the literature. We present a case of a patient with concurrent right ureterosciatic hernia (Lindbom hernia), ipsilateral bladder hernia, and appendix-containing inguinal hernia (Amyand hernia). These findings were discovered incidentally on imaging and the patient had no associated symptoms.

Inguinal bladder hernia is a rare clinical condition, and only a small number of reported cases have been treated by laparoscopic surgery. In the present case, the patient was a 78-year-old man who presented to our emergency department with a chief complaint of right inguinal bulge and pain. CT imaging revealed an incarcerated right inguinal hernia containing the small intestine and a portion of the urinary bladder. We performed manual reduction of the incarcerated intestine, and he was admitted to the surgical ward for follow-up. On the 19th day after discharge, recurrence of incarceration developed, and he was readmitted after manual reduction. A laparoscopic transabdominal preperitoneal repair was performed. After careful reduction of the protruding bladder from the hernial orifice, we repaired the right inguinal hernia with a mesh prosthesis. We experienced a rare case of right indirect inguinal bladder hernia that was treated successfully with laparoscopic repair.

Inguinoscrotal bladder hernia is rarely encountered relative to the common occurrence of inguinal hernia. Most patients are asymptomatic and diagnosed perioperatively; however, lower urinary tract symptoms along with swelling in the inguinal region and two-stage urination may suggest herniated bladder. Co-occurrence of inguinoscrotal bladder hernia and herniated bladder stone is extremely rare, and there is no consensus on its treatment. Herein, we will present the case of an 81-year-old male patient with an inguinoscrotal bladder hernia and herniated bladder stone. To our knowledge, this is the seventh case reported in the literature thus far.

Inguinal herniation of urinary bladder is a rare condition which might associated with significant complication. Exact pre-operative diagnosis is extremely important. We reported a case of huge inguinoscrotal bladder hernia, associated with bilateral hydronephrosis and kidney injuries, managed by laparoscopy technique.

Case Summary An 86-year-old male nursing home resident presented with increasing confusion and was initially treated for catheter-associated urinary tract infection. CT scan demonstrated acute acalculous cholecystitis and complete inguinal bladder hernia with compression of right vesico-ureteric junction leading to acute obstructive renal failure. Percutaneous cholecystostomy and percutaneous nephrostomy were attempted but were not possible due to patient non-compliance. Patient improved with conservative management. Discussion Bladder involvement in inguinal herniae is rare with most cases being identified at the time of hernia repair and there is a 17% risk of intra-operative bladder injury. Key risk factors include increasing age, male gender, lower urinary tract symptoms and previous hernia repair. Percutaneous nephrostomy followed by inguinal hernia repair is the treatment of choice for most patients. Clinicians should aim to make the diagnosis of inguinal bladder hernia pre-operatively to reduce risk of intra-operative bladder injury during hernia repair. Acute acalculous cholecystitis tends to occur in critically ill patients and is a marker of poor prognosis.

Inguinal hernia is a common disorder that requires urgent and adequate surgical management. Multiple organs may be associated with inguinal hernias, but bladder involvement is rarely seen. The diagnosis is frequently done during surgery. It can be evoked before surgery when the patient presents with irritative and obstructive lower urinary tract symptoms. Retrograde urethrocystography or intravenous urography confirms the diagnosis. We report a case of inguinal hernia involving the bladder at the right side with a 72-year-old man. We performed a hernia repair after reintegration of the bladder.

Background: Inguinal herniation of the urinary bladder is rare. Although in most patients it is an incidental finding during hernia repair, some patients present with complications related to herniated bladder. Case Presentation: A 65-year-old man presented with recurrent lower urinary tract infections and multiple episodes of lithuria. He was found to have an incarcerated right inguinal hernia with a large part of the urinary bladder inside the hernial sac. He did not have any features of bladder outlet obstruction. The herniated bladder had multiple small secondary vesical calculi that had probably formed in this hernial sac. He was managed by open surgical mesh hernioplasty followed by cystoscopic stone evacuation. Conclusion: Incarcerated bladder herniation, complicated by intravesical stone formation, is a rare clinical condition. Proper preoperative imaging with CT scan best confirms the diagnosis. Appropriate treatment includes reduction of the bladder, hernia repair, and endoscopic stone management.

Introduction Inguinal bladder hernia (IBH) is a rare condition representing less than 5% of all inguinal hernias. Most cases occur in elderly overweight men. Patients may present with variable symptoms such as urinary symptoms, inguinal swelling, or pain; however, most of them are asymptomatic and only less than 7% are diagnosed pre-operatively. Different radiological studies can be used if IBH suspected preoperatively including ultrasound, computed tomography scan; however, cystography is the most sensitive test for diagnosis of IBH. Open reduction and hernia repair are the standard treatment of IBH. Case presentation We report a rare case of an-83-year-old male who presented with left inguinal pain associated with lower urinary tract symptoms including dysuria, nocturia, post-voidal dribbling, and urinary frequency. Laboratory studies showed acute kidney injury (AKI), and computed tomography (CT) of abdomen and pelvis without contrast CT revealed a herniation of 80% of the bladder through the left inguinal canal into the left scrotal sac, with moderate bilateral hydronephrosis and hydroureter, though no obstructing calculi are seen. Pre-operative diagnosis of incarcerated inguinal bladder hernia (IBH) was made, and a timely surgical intervention preceded by bladder catheterization led to a significant improvement of AKI and an excellent outcome without post-operative complications. Discussion and conclusion IBH is uncommon condition that can present with non-specific urinary symptoms; therefore, high index of suspicion is mandated for diagnosis especially in patients with risk factors. Pre-operative radiological evaluation to avoid iatrogenic bladder injury with subsequent surgical repair is the standard management for IBH as we accomplished in our case., Highlights • Consider inguinal bladder hernia in patients with urinary symptoms and large inguinal hernia. • Proper evaluation and pre-operative diagnosis of inguinal bladder hernia is important to prevent any iatrogenic bladder injury. • Pre-operative urinary catheterization and surgical repair is the treatment of choice in inguinal bladder hernia.

Highlights • Inguinal bladder hernia (IBH) is a rare condition that is difficult to diagnose preoperatively. • 16% of IBHs are diagnosed postoperatively due to bladder injury and leakage. • Preoperative diagnosis of IBHs is important to lessen postoperative complications. • Transabdominal preperitoneal approach can significantly reduce the risk of bladder damage., Introduction Inguinal bladder hernia (IBH) is a rare condition that is difficult to diagnose preoperatively based only on physical examination; 16% of IBHs are diagnosed postoperatively due to complications. Presentation of case We report the case of a 56-year-old man who presented with left inguinal swelling and increased frequency of urination since eight years. Physical examination demonstrated a 6 × 4 cm non-reducible left inguinal bulge with mild tenderness on palpation. Computed tomography revealed a left inguinal hernia containing a portion of the urinary bladder. He was diagnosed with IBH and transabdominal preperitoneal (TAPP) repair was performed. We confirmed a left internal inguinal hernia and incised the peritoneum from the outside of the left inguinal ring. The preperitoneal space was dissected toward the Retzius space, and the prolapsed bladder was examined. The adhesion with the surroundings was carefully dissected and the bladder was reduced into the abdomen. Indigo carmine was injected through a urinary catheter, which confirmed that no bladder damage had occurred. After the mesh was positioned to cover the myopectineal orifice, it was fixed to the Cooper’s ligaments, interior side, lateral side, and ventral side. The postoperative course was uneventful, and the patient is now free of symptoms and recurrence two months after surgery. Conclusion TAPP repair is a useful treatment for IBH. Preoperative diagnosis of IBH is important to lessen postoperative complications.

Mesanenin inguinal kanal icerisine herniasyonu tum inguinal hernili olgularin %1- 3’unde gorulur ve genis inguinoskrotal mesane herniasyonu oldukca nadir olarak karsimiza cikmaktadir. Genellikle asemptomatik olup rastlantisal olarak tani konmaktadir. Inguinal herni operasyonu sirasinda gelisebilecek komplikasyonlari onlemek acisindan preoperatif donemde tespit edilmesi onem tasimaktadir. Inguinoskrotal hernilerin temel tedavisi cerrahi onarimdir. Biz bu yazimizda masif inguinoskrotal mesane herniasyonu olan 3 olgumuzu literatur esliginde sunmayi amacladik.

Although inguinal bladder hernia associated with obstructive uropathy is an extremely rare entity, it should be suspected in elderly patients with bladder outlet obstruction presented with inguinal hernia and lower urinary tract symptoms.

Introduction Bladder hernia is relatively rare in cases of inguinal hernia. In some instances, bladder hernia may be treated as inguinal hernia if bladder prolapse is not recognized. Because of the rarity of inguinal bladder hernias, there are no related detailed reports from studies performed at a single institution. In our hospital, patients with suspected inguinal hernia undergo CT in the prone position, enabling the diagnosis of bladder hernia preoperatively. This study aimed to clarify the clinical characteristics of inguinal bladder hernias and consider noteworthy points in their laparoscopic treatment. Methods This retrospective analysis included data from 32 consecutive patients with bladder hernia in 1126 patients with inguinal hernia. In each patient, the lengths of the hernial orifice and prolapsed bladder were measured on the CT images and intraoperatively. Totally extraperitoneal (TEP) repair was performed in all patients, who were then followed for 1 year postoperatively. Results Inguinal bladder hernia was detected on CT in 32 of 1126 patients (2.8%). Among them, only five (15.6%) had urological symptoms such as pollakiuria or the sensation of residual urine. The 32 patients were classified into three groups according to hernia subtype: intraperitoneal (n = 12, 37.5%), para-peritoneal (n = 15, 46.9%), and extraperitoneal (n = 5, 15.6%). The prolapsed bladder of the extraperitoneal type was significantly shorter than that of the other subtypes. The prolapsed bladders were directly identified in the extraperitoneal space and repaired safely with TEP. One recurrence (3.1%) occurred 2 months postoperatively. Conclusion Preoperative CT and TEP are useful for the definitive diagnosis and treatment of inguinal bladder hernia.

Highlights • Inguinal bladder hernia is an unusual condition that requires a high index of clinical suspicion for diagnosis. • This case demonstrates the importance of preoperative diagnosis in avoiding surgical complications including bladder injury., Introduction Cases of inguinal bladder hernia are rare, with bladder involvement seen in 1–4% of inguinal hernias. The majority of cases are diagnosed intraoperatively, with only 7% of bladder hernias identified prior to surgery. Diagnosis may be challenging as patients are often asymptomatic or have nonspecific symptoms. Surgical repair is currently the standard treatment, and careful surgical planning is necessary to avoid complications including bladder injury. Presentation of case A 58-year-old man presented to our Emergency Department with 2-day history of progressively worsening left lower quadrant pain, groin bulge, and dysuria. Physical exam revealed an irreducible left inguinal hernia associated with urinary urgency on attempted reduction. Plain CT was ordered and demonstrated inguinal hernia with bladder protrusion into the left scrotum. The patient underwent open surgical reduction and hernia repair and made a quick postoperative recovery without complications. Discussion Inguinal bladder hernia most often presents in older, obese males and clinicians should have a high index of suspicion when assessing patients with inguinal hernia. Preoperative diagnosis based on history, physical, and radiologic imaging allow for careful surgical planning and prevention of severe complications including bladder injury and leakage. Conclusion We present a case report of inguinal bladder hernia in a middle-aged man that presented as left lower quadrant pain, groin pain, and dysuria. Diagnosis was confirmed preoperatively with radiographic imaging. The hernia was surgically reduced and the defect repaired without complications.

Inguinal mesane hernisi, mesanenin inguinal kanal, skrotal kese veya femoral kanala fitiklasmasi sonucu ortaya cikan, sik rastlanmayan ve genellikle belirti vermeyen bir durumdur. Kemik sintigrafisinde rastlantisal olarak saptanan inguinal mesane hernisi literaturde nadir olup genellikle tani ultrasonografi veya bilgisayarli tomografi ile dogrulanmistir. Tek foton emisyonlu bilgisayarli tomografi/bilgisayarli tomografi (SPECT/BT) tetkiki planar goruntulemede saptanan anormal aktivitenin net yerlesiminin saptanmasinda ve degerlendirilmesinde yararli olmaktadir. Bu calismada, 65 yasindaki prostat kanseri tanili erkek olguda saptanan, kemik sintigrafisinde pubik kemik metastazini taklit eden ve SPECT/BT goruntuleme ile tani alan inguinoskrotal mesane hernisinin sunulmasi amaclanmistir.

It is extremely uncommon for bladder carcinoma to manifest in an inguinal hernia. Only 1-3% of inguinal hernias involve the bladder, and very few of these hernias are associated with bladder carcinoma. Furthermore, the tumour is removed, and the hernia is repaired as part of the treatment. We present the case of an 89-year-old man who came to our clinic complaining of haematuria and was diagnosed with an inguinal bladder hernia filled with tumours.

Bladder herniation through the inguinal canal is a rare condition, accounting for only 1–4% of all inguinal hernias. Most patients are asymptomatic or have atypical symptoms. 65-year-old male who presented with gross hematuria, right inguinal swelling. Diagnosed preoperatively by CT scan to have bladder neoplasm within a right inguinal vesical hernia. Patient. Underwent TURBT and hernia repair. Inguinal bladder hernia is rare and occurs more commonly in obese male patients above 50 years of age. CT scan is the radiological modality choice to confirm the diagnosis prior intervention to avoid intraoperative complications such as bladder injury.

Inguinoscrotal hernia of the bladder is relatively uncommon, difficult to diagnose and remain a surgical challenge.[1,2,3,4] We report a 72-years-old man with a recent diagnosis of prostate neoplasm who underwent a Technetium-99 hidroximethylene-diphosphonate (Tc-99m HMDP) bone scintigraphy which reveals, as an incidental finding, a left inguinoscrotal hernia containing a portion of the urinary bladder.

Here, we present a case of a 60-year-old male patient with inguinoscrotal bladder hernia and a bladder tumor who underwent cystoscopy and had no transurethral access. On the images, a massive inguinoscrotal hernia and a mass of 2.8 cm in diameter in the bladder were seen. First of all, hernia was repaired. Transurethral resection of the tumor was then performed. The tumor was in the posterior wall. High-grade T2 urothelial carcinoma was detected. The patient was offered radical surgery but he refused the operation. Multimodal therapy was recommended for the patient.

Highlights • Inguinal bladder hernia was accidentally found during surgical procedure for incarcerated inguinal hernia. • During procedure urinary bladder wall was lesioned. • Physicians should think of this condition in elderly, obese male, with sudden onset of lower urinary tract symptoms. • Treatment of this condition is surgical, exception are unfit, asymptomatic patients. • Urologist should be consulted to exclude urological malignancy – bladder cancer., Introduction Inguinal bladder hernia is rare condition found in about 1–5% of inguinal hernias. The condition is usually diagnosed intraoperatively. Patients rarely have symptoms regarding urinary tract. The best management is surgical, open surgical technique is preferred over laparoscopic. Possible urinary tract damage during surgery should be recognized and resolved. Case presentation The following paper presents case of inguinal bladder hernia in 82-year old Caucasian male. Patient presented at our emergency department with incarcerated left inguinal hernia. Preoperative ultrasound has shown small bowel loop inside hernia sac. The condition was diagnosed intraoperatively – the whole bladder was found inside hernia sac. During surgery minor damage of the bladder was caused and repaired. Hernia defect was repaired using Bassini hernioplasty. Discussion Elderly male more often present with inguinal bladder hernia. Sometimes urinary malignancy may be cause for inguinal bladder hernia. In cases where inguinal bladder is found inside hernia sac, urologist should be consulted to exclude urological pathology. Surgical treatment is indicated in all symptomatic patients. Patients with small, asymptomatic inguinal bladder hernias could be treated conservatively. Conclusion Physicians seeing patients with inguinal hernia should be aware that patient may have inguinal bladder hernia, especially in patients presenting with newly developed symptoms of lower urinary tract.

ZusammenfassungInguinale Blasenhernien machen unter allen Leistenhernien nur 1 – 4 % aus. Die Diagnosestellung kann aufgrund der atypischen Symptome erschwert sein und wird oft erst intraoperativ diagnostiziert. Umso wichtiger ist, es die Diagnose präoperativ zu stellen, um evtl. iatrogene Komplikationen zu vermeiden.Wir berichten über eine Fallserie von 5 Patienten in den letzten 20 Jahren, welche mit der seltenen Pathologie einer Blasenhernie in unserer Abteilung therapiert wurden.

Hernia surgery is the most frequent in visceral surgery. The bladder is rarely involved in groin hernia. This is when a diverticulum or a part of the bladder wall is incarcerated within the hernia. This affection is often asymptomatic. The diagnosis is made per-or post-operatively following complications. We report 2 cases of inguinal hernia involving the bladder in which the first case was diagnosed preoperatively whereas the second was diagnosed intraoperatively., Fıtık cerrahisi viseral cerrahide en sık görülenidir. Mesane nadiren kasık fıtığı ile ilişkilidir. Bu, divertikülün veya mesane duvarının bir bölümünün fıtık içinde hapsedilmesidir. Bu durum genellikle asemptomatiktir. Tanı komplikasyonları takiben ameliyat sonrası veya sonrasında yapılır. Bu çalışmada iki kasık mesane fıtığı olgusunu sunuyoruz, mesane ilişkisi birinci vakada preoperatif tanı ile, ikinci vakada intraoperatif olarak teşhis edildi.

A 70-year-old man was referred to the Urology Service of our University Hospital for an irregular thickening of the left anterior–lateral urinary bladder wall found in a computed tomography scan following gross haematuria. In particular, the computed tomography scan showed irregularity of the mucosal aspect and an irregular thickening of the bladder wall in close proximity of an inguinal hernia. The computed tomography exam also showed an unusual little fatty seizure in the parietal planes. A magnetic resonance imaging confirmed the thickening in the same area as the hernia with a mainly extraluminal presentation and extension in the perivesical adipose tissue. Cystoscopy did not show alteration of the mucosal surface. Urine cytology showed normal urothelium cells. At the time of the left inguinal hernia repair, the bladder was isolated from the inguinal hernia fat tissue and then opened with median cystotomy. Biopsy of the anterior–lateral bladder wall showed normal urothelium and an abundant component of mature lobules of adipose tissue in the sub-epithelial connective tissue extending among the muscle bundles of muscularis propria, compatible with a diagnosis of lipomatosis, a very rare lesion in the urinary bladder.

Herniation of the urinary bladder is observed in around 1%–4% of cases. Bladder herniation rarely presents with obstructive uropathy; however, bladder herniation carrying ureteroneocystostomy and leading to obstructive uropathy of the graft is even rare. Here, we present a case of a 36-year-old male with deranged renal function test who had undergone renal transplant 10 years back. Computed tomography scan revealed bladder herniation with ureteroneocystostomy and hydronephrosis. He was surgically explored by Gibson incision and ureterolysis, and hernioplasty was performed. Although the cause of herniation was ureteroneocystostomy, it was managed immediately without any need for percutaneous nephrostomy.

Rationale: Sliding inguinal hernias of the urinary bladder are protrusions of the bladder through the internal inguinal ring, most of which are insignificant and diagnosed intra-operatively. Large inguino-scrotal bladder hernias commonly present with lower urinary tract symptoms and may cause severe complications, including bladder incarceration or necrosis, bladder hemorrhage, obstructive or neurogenic bladder dysfunction, and even renal failure. Patient concerns: We describe and discuss the clinical findings and management of a 59-year-old man who complained of a decrease in scrotal size after voiding and 2-stage voiding requiring pressure to the scrotum. Diagnoses: The patient was diagnosed preoperatively as massive, bilateral, inguinoscrotal hernias, and a large, left-sided, sliding bladder hernia. Interventions: The patient underwent a timely open re-peritoneal inguinal herniorrhaphy using a mesh. Outcomes: The surgical outcomes were good, and no surgical site infection, chronic postoperative inguinal pain or recurrence were recorded during the follow-up. Lessons: Better knowledge of this rare condition of large inguino-scrotal sliding bladder hernia could help in making a correct diagnosis preoperatively and provide proper surgical management timely, so as to reduce delay in treatment and avoid potential complications.

Type 3 internal hemipelvectomy involves resection of the pubis. We report on 2 patients who underwent type 3 internal hemipelvectomy. One patient developed a bladder hernia, tumour recurrence, and a pathological fracture of the proximal femur. These were resolved with external hemipelvectomy 7 months later. Another patient underwent additional fascia lata transplantation to prevent development of hernia. Both patients had a stress fracture in the contralateral posterior ilium mimicking bone metastasis.

Inguino-scrotal sliding hernia of the bladder (IBH) is a rare condition. Frequently, it is asymptomatic but sometimes it can be complicated by urosepsis and incarceration.A 74-year-old male with an IBH was admitted to the intensive care unit with urosepsis, acute renal insufficiency and incarceration of the herniated bladder. A two-step approach was performed to repair this complicated hernia. Firstly, the incarcerated bladder was reduced during a laparoscopic, trans-abdominal approach. Ten days later - after treatment of the urosepsis with antibiotics and normalisation of the inflammatory parameters - a Lichtenstein hernia repair was completed. The laparoscopic approach allowed correcting the acute incarceration of the bladder with possibility to inspect the bladder for iatrogenic bladder perforation. And after treating the urosepsis with adequate antibiotics, the second step was performed through an open Lichtenstein hernia repair, thus minimising the risk of mesh infection.In case of an IBH, complicated by urosepsis, a laparoscopic reduction of the herniated bladder followed by a Lichtenstein hernia repair in a second time is a valid option.

Introduction. Although a recurrent inguinal hernia is sometimes observed as a supravesical hernia, it is extremely rare to encounter a bilateral bladder sliding hernia recurrence. In this report, we describe an extremely rare case of a recurrent bilateral supravesical bladder hernia after bilateral transabdominal preperitoneal repair (B-TAPP). Case Presentation. A 69-year-old man visited our hospital with complaints of bilateral groin swelling and frequent voiding after B-TAPP. A plain CT revealed that the urinary bladder was herniating into the bilateral supravesical hernias. He underwent laparoscopic bilateral supravesical bladder hernia repair using a bladder takedown approach and median TAPP. Discussion. In Japan, the current mainstream method of hernioplasty is TAPP. However, an immature surgical technique and inadequate mesh placement may increase the risk of recurrent hernias. We successfully repaired this patient’s recurrent bilateral supravesical bladder hernias laparoscopically. Conclusion. This rare condition (recurrent bilateral supravesical bladder hernias after B-TAPP) was successfully treated by using the bladder takedown approach and median TAPP. During surgical training and later in clinical practice, surgeons should master a surgical technique for this procedure in order to reduce recurrent hernias.

An 82-year-old man with a history of renal transplantation 14 years earlier presented with acute obstructive renal failure secondary to inguinal herniation of the urinary bladder complicated by ureteroneocystostomy entrapment. After percutaneous nephrostomy tube and endoscopic stent placement, the bladder was reduced and the hernia repaired with the use of a preperitoneal mesh. The postoperative course was uneventful and the renal function returned to normal. Inguinal herniation of the transplant ureter is a rare cause of hydronephrosis, but it has been described in the literature. Bladder hernias do usually not cause urologic complications in the nontransplanted patient, but they can present as an emergency after renal transplantation.

A 72-year-old male with a history of prostate cancer and high prostate specific antigen levels underwent 99mtechnetium-methylene diphosphonate (99mTc-MDP) single-photon emission computed tomography/computed tomography (SPECT/CT), to identify bone metastasis. The patient possessed no previous history of serious illnesses or surgical procedures and no family history of malignancies. A whole-body CT scan revealed an intense MDP uptake in the right inguinal region on the anterior view, but not in the posterior view, which was suspected to be a metastatic lesion. However, there was no evidence of bone metastasis on the CT scan. In addition, an increased 99mTc-MDP uptake was indicated on the SPECT images in the right inguinal region, which appeared to be separate from the main bladder activity. CT images of the pelvis revealed an inferior tongue-like extension of the bladder into the right inguinal region. Fused SPECT/CT axial images indicated the circular accumulation of the 99mTc-MDP in the medial right groin, with well-defined walls that connected the accumulation to the bladder. The final diagnosis was a bladder hernia (T2N0M0), which may have been responsible for the misdiagnosis of bone metastasis due to the use of radiopharmaceuticals (99mTc-MDP) that were mainly excreted through urination. Considering the comprehensive situation of the patient, radical prostatectomy was performed. The bladder hernia was subsequently monitored by follow-up examination every 3 months, and remains alive and under follow-up to date.

We herein report the case of a 68-year-old male who presented with a few years' history of swelling at the scar of an appendectomy, which he had undergone nearly 40 years earlier, and which was associated with radiating pain towards the penis when he pushed on the swelling. The scar was located in the right lower quadrant of the abdomen. Abdominal sonography and a computed tomography (CT) scan demonstrated the presence of an incisional bladder hernia, and surgery was performed. The herniated bladder was successfully replaced into the preperitoneal space, and the orifice was covered with a polypropylene mesh. Most bladder hernias develop in the inguinal and/or femoral region, and an incisional bladder hernia is extremely rare, especially after abdominal surgery. To our knowledge, this is the fourth report of an incisional bladder hernia following abdominal surgery.

Background Inguinal hernia repair is the most common surgical procedure in babies. Despite a meticulous technique, relapses may occur. The occurrence of a direct bladder wall hernia in relapses has never before been reported in the literature. Case presentation Here, we report two cases of direct bladder herniation: a white baby boy born after 25 weeks of gestation and a white baby boy born after 26 weeks of gestation. Both of the formerly extremely low birth weight babies were affected after open bilateral hernia repair. Recurrent hernias developed on the right side, and direct bladder herniation was identified intraoperatively. In one case, laparoscopy was applied to identify a supravesical type of hernia. Immaturity and a difficult postnatal course might have contributed to hernia relapse in these cases. Conclusions Misinterpretation of bladder herniation might have disastrous consequences. Laparoscopy is a helpful tool in comparable cases.