Complete scrotal urinary bladder hernia with both ureters and small intestine presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency.
We report a case of a complete scrotal bladder hernia with both ureters presenting as dysuria, bilateral ureterohydronephrosis, and acute renal insufficiency. A 37-year-old man with a recurrent large scrotal mass after two surgeries, suffering with small urinary symptoms as a dysuria and nocturia, was examined before the third surgery on an outpatient basis. Urological examination revealed a negative urine, bilateral large ureterohydronephrosis on USG, and serum creatinine 231-250 µmol/l. CT displayed the urinary bladder completely herniated into the scrotum with distal parts of both ureters and small intestine, and bilateral large ureterohydronephrosis. After admission to urological department on retrograde cystography a completely herniation of the urinary bladder with residual urine more than 250 ml was confirmed. A permanent catheter was indwelled. The hernia was explored with urinary bladder repositioning. Because bilateral ureteral obstruction on USG did not retreat, a bilateral percutaneous nephrostomy was done. The patient's serum creatinine markedly improved, also hernia and ureterohydronephrosis was repaired with normally moisten without residual urine (Fig. 2, Ref. 26).
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D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D053159:Dysuria / Q000209:etiology; D006547:Hernia / Q000150:complications* / Q000473:pathology*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D012611:Scrotum / Q000473:pathology*; D014513:Ureter / Q000473:pathology*; D001743:Urinary Bladder / Q000473:pathology*