Advantages of minimally invasive approach for inguinal bladder hernia repair: case report and literature review

: Inguinal bladder hernia (IBH) is a rare disease, with only 73 adult cases being reported in Medline over the past decade, 75 cases including the present report. Its preoperative diagnosis is difficult without typical presentation; however, the three most common signs/symptoms are urinary frequency, two-stage urination and acute kidney injury (AKI). Prompt diagnosis should be made in patients presenting with an inguinoscrotal mass along with the aforementioned symptoms. According to a review of the literature of the last decade, 93.3% of IBH diagnoses were made prior to surgery, compared to fewer than 10% in the past century. However, documented cases show that IBH is associated with significant complications if diagnosis is delayed. In addition, there were no reports on the laparoscopic extended-totally extraperitoneal (eTEP) in such cases. Herein, we report 2 cases of IBH along with the literature review. The first patient was diagnosed with IBH during open hernioplasty using saline insufflation via a Foley’s catheter. The second patient presented as an early recurrence, with incarceration after ipsilateral open hernioplasty. This case was diagnosed and successfully treated by eTEP repair. All patients recovered without complications. We aimed to report the diagnosis and surgical approach in IBH along with evidence-based discussion from published studies. The eTEP approach was feasible and safe for the treatment of an incarcerated extraperitoneal type of IBH. The advantages of a minimally invasive approach for IBH are discussed in this report.