Abstract
A 74-year-old man noticed a swelling on the right side of his groin and visited our hospital. We advised him to undergo observation because we were unable to palpate a groin hernia in the initial examination and could not detect swelling on computed tomography in the supine position. Five months later, he revisited to our hospital with the same symptoms. Computed tomography in the prone position revealed that his bladder had prolapsed inside a right inferior epigastric vessel. Thus, he was diagnosed as having a bladder hernia in the right groin area. The operative findings showed the hernia orifice inside a right inferior epigastric vessel, which we diagnosed as a paraperitoneal bladder hernia. At the hernia orifice, we separated the para-bladder fat from the transversalis fascia to the midline. We were unable to see the wall of the bladder during the operation. A Japan Hernia Society type II-3 groin hernia orifice was detected after preparation of the preperitoneal space. We repaired the bladder hernia by using a Bard® 3D-Max Light Mesh. Only few case reports have described the repair of a bladder hernia by using the transabdominal preperitoneal approach. This case also highlights the usefulness of prone-position computed tomography.
