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From the Department of Urology, Nagai() General Hospital
Atsushi Seyama and Tomita Nakayama
From the Department of Surgery, Nagato General Hospital
Motohiko Konishi, Keiji Joko, Hiroshi Takihara
and Jisaburo Sakatoku
From the Department of Urology, Yamaguchi University School of Medicine
Kazunari Tanaka
From the Second Department of Pathology, Yamaguchi University School of Medicine
A 72-year-old man complained of right hemiscrotal swelling and pollakisuria which had appeared 3 days after herniorrhaphy. On physical examination, a large mass in the right scrotum did not transmit light nor shrink upon pressure application. The concentrations of blood urea nitrogen and creatinine in the fluid obtained by puncture from the scrotal mass were high. Cysto-
graphy demonstrated influx of contrast media into the scrotal mass from the bladder. From these findings, diagnosis was made as herniation of the bladder. An operation was performed through inguinoscrotal incision. The herniated bladder, to which peritoneum was laterally adherent, was incarcerated. The hernia ring, which was located medially to the suture line of previous hernior-raphy, had strangulated the herniated bladder. The bladder wall was edematous and the mucosa was dark red. These findings suggested that the blood circulation in the herniated bladder had been disturbed for a relatively long time. Resection of the herniated bladder with the adherent
peritoneum was performed in addition to hernia repair. Imcomplete herniorrhaphy may be one of the causes of herniation of the bladder in our case.
(Acta Urol. Jpn. 38: 455-458, 1992)
Key words: Herniation of the bladder, Herniorrhaphy