Scrotal Cystocele with Two-phase Micturition.

An 86-year-old man presented with a 1-month history of frequent urination and a sense of residual urine. He had a nine-year history of a painless mass in the right groin spreading gradually into the scrotum. The mass showed swelling, especially when he stood up or held his urine. The patient needed to compress the scrotal swelling in order to complete voiding. A physical examination revealed a bulky non-tender, palpable mass in the right groin. Computed tomography of the abdomen showed a dumbbell-shaped extension of the bladder into the right scrotum through the right inguinal canal (Picture). We suggested surgical repair, but the patient declined the treatment. Herniation of the urinary bladder into the inguinal canal is rare and accounts for 1-3% of all inguinal hernias (1). Scrotal cystocele is a type of urinary bladder hernia wherein the bladder herniates into the scrotum. The typical symptom of two-phase micturition, involving spontaneous bladder emptying with a second stage of manual compression of the hernia, is a useful clue for the diagnosis (2).

Picture.

The authors state that they have no Conflict of Interest (COI).