Large Bladder Stone Found in Recurrent Inguinal Hernia Following Prostatectomy

A 72-year-old male patient presented with a ten-year history of a right groin mass accompanied by lower urinary tract symptoms, including urgency, frequency, and dysuria, along with several months of hematuria. According to a case report published in BMC Surgery, subsequent evaluations revealed that the patient had developed a recurrent inguinal hernia that involved a segment of the urinary bladder housing a large vesical calculus.

The patient’s clinical background included two previous inguinal hernia repairs and an open transvesical prostatectomy performed 18 months earlier to treat benign prostatic hyperplasia. A vesical stone had been detected preoperatively via ultrasonography prior to that procedure; however, surgeons could not locate the calculus during the operation, leading them to stop the extraction attempt at that time.

Because the patient experienced persistent complaints and groin pain, clinicians initiated further diagnostic investigations. Both ultrasonography and computed tomography imaging revealed a recurrent inguinal hernia containing a bladder component and an enclosed calculus measuring 3 by 3 centimeters. Although recommended for diagnostic evaluation, preoperative cystoscopy was not performed because the patient refused the intervention.

Surgical exploration of the groin confirmed an extraperitoneal direct inguinal hernia containing the bladder and the stone within the herniated portion. Clinicians performed a cystolithotomy to extract the calculus, which measured 3.2 by 3.0 centimeters and consisted primarily of calcium oxalate monohydrate. Following extraction, the cystotomy was closed in two layers, and the hernia was repaired using the Shouldice method reinforced with additional polypropylene mesh.

The patient experienced an uneventful postoperative recovery and remained symptom-free at a one-year follow-up examination, exhibiting no clinical evidence of hernia recurrence and no radiological remnants of the calculus on plain abdominal radiography.

According to the case report, a vesical hernia traversing the inguinal canal represents an uncommon variant of a sliding hernia associated with bladder outlet obstruction in older men. The authors observed that vesical calculi situated within a herniated segment of the bladder are extremely rare and often missed during clinical assessment.

The authors emphasized that if a known vesical stone cannot be located during an operative intervention, further investigation is required because of its potential presence inside a herniated bladder segment.

Subject of Research: Recurrent inguinal bladder hernia containing a vesical calculus

Article Title: Recurrent inguinal bladder hernia containing a large vesical calculus after unsuccessful stone retrieval during transvesical prostatectomy: a case report

Article References: Bin-Sahel, O. H. A., Bajubair, E. M. O., Sadaqat, A., Javaid, M. H., & Batyour, A. B. M. (2026). Recurrent inguinal bladder hernia containing a large vesical calculus after unsuccessful stone retrieval during transvesical prostatectomy: a case report. BMC Surgery. https://doi.org/10.1186/s12893-026-04334-9

Image Credits: AI Generated

DOI: 10.1186/s12893-026-04334-9

Keywords: inguinal hernia, bladder hernia, vesical calculus, cystolithotomy, prostatectomy, urology, Shouldice repair, computed tomography, Recurrent, inguinal, bladder, hernia