Urinary bladder herniation: CT evaluation

Abstract

Purpose: To evaluate the role of computed tomography (CT) in the diagnosis and characterization of urinary bladder herniation, an uncommon and often underdiagnosed condition, with emphasis on its anatomical patterns and imaging features essential for accurate diagnosis and preoperative planning.
Materials and Methods: A retrospective review was conducted over a six-year period, from January 2019 to May 2025. Inclusion criteria were (1) imaging-confirmed urinary bladder herniation and (2) availability of complete clinical history, including presenting symptoms and physical examination findings. Imaging protocols included pre-contrast, post-contrast, and delayed-phase scans with a focus on the lower pelvis. Multiplanar reconstructions
were routinely performed.
Results: Urinary bladder herniation was identified in six patients, in which four of them the herniated bladder extended into the scrotum, consistent with inguinoscrotal herniation. Four of the patients were diagnosed incidentally on CT scans for other
purpose and two presented with symptoms. All hernias were unilateral, with five
occurring on the right side and one on the left. The cohort included four male and two
female patients.
Conclusions: Urinary bladder herniation is a rare condition but should always be considered in the
differential diagnosis of inguinal hernias, particularly in older male patients. CT imaging plays a pivotal role in the detection and evaluation of urinary bladder herniation, providing crucial information for diagnosis and surgical planning.