Sliding hernia of the urinary bladder in 32 cases / 中华普通外科杂志

ABSTRACT

Objective To improve the diagnosis and treatment of sliding hernia of adult urinary bladder. Methods Clinical data of 32 cases of adult sliding hernia of the bladder from 1984 to 2009 were analyzed retrospectively. Discomfort was complained in all the 32 patients along with palpable mass. Twentynine cases suffered from urgency of micturition, ascheturesis and dysuria, 15 cases had interruption of urination. The mass was saddle-shaped in 29 cases, when the bladder was filling. In all the 32 cases of hernia block were in a sense of fluctuations and flat on percussion. In 26 cases the bladder appeared a dumbbell-shaped image on cystography. By B-ultrasonic examination an opaque dark area of fluid was detected in 29 cases when there was retention of urine. Results Preoperatively 29 cases were diagnosed of bladder sliding hernia, 3 cases with misdiagnosis ( misdiagnosis rate of 9.4% ). 32 cases were cured by surgical treatment. The prolapsed portion of the bladder including stones in 2 cases were resected. 32 cases were followed up from 1 to 5 years without recurrence. Conclusions Once the sliding hernia of the bladder is diagnosed, patient should receive surgery. Intraoperatively the key of preventing inadvertent cut or missed diagnosis is familiar with pathological anatomy and careful exploration.