Massive inguinoscrotal hernia successfully repaired with laparoscopic total extraperitoneal hernia repair (T.E.P.): case report

Abstract

Inguinal hernia is a common surgical condition. It accounts for 75% of all abdominal wall hernias with a life-time risk of 27-43% in men and 3-6% in women. Even though extensive inguinoscrotal herniation of bladder is extremely rare, the bladder may be involved in up to 4% of all inguinal hernia cases. Majority of the patients presented with classical hernia symptoms with seldom complaints of urinary symptoms such as voiding related scrotal swelling, two-stage micturition (a first spontaneous voiding followed by a second requiring manual compression of the inguinoscrotal region), urinary tract infections, or irritative lower urinary tract symptoms (LUTS) such as urgency, frequency, and nocturia. Since the presentation is near identical to classic inguinal hernia, most of the cases were diagnosed intraoperatively and increasing the risk of accidental bladder injury. Only 10% of this condition can be diagnosed preoperatively. Surgical repair of hernia is the mainstay of the treatment which open techniques are the majority. We report the successfully laparoscopic total extraperitoneal hernia repair (T.E.P) for an extensive inguinoscrotal bladder hernia.