A Case of Recurrent Extraperitoneal Inguinal Bladder Hernia Using a Totally Extraperitoneal Approach (TEP)

Abstract

A 52-year-old man who had undergone mesh hernioplasty for a right inguinal hernia 10 years ago presented with a complaint of right inguinal region discomfort for 2 weeks. At the initial examination, a 5-cm bulge was found in the right inguinal region, which easily reduced in the supine position. Computed tomography in the prone position showed that the bladder prolapsed inside an inferior epigastric vessel. A right inguinal bladder hernia was diagnosed, and the transabdominal preperitoneal approach procedure (TAPP) was planned. However, no hernial orifice was found on the abdominal wall. Therefore, an extraperitoneal bladder hernia was diagnosed, and the procedure was quickly changed to the totally extraperitoneal approach procedure (TEP). A mesh was placed to cover the 1-cm hernia orifice. The patient's postoperative course was uneventful. This case showed that the TEP procedure is more helpful for extraperitoneal bladder hernia in identifying the hernial orifice and avoiding bladder injury.