Herniation of the Urinary Bladder Into the Scrotal Sac With Intrascrotal Perforation: A Report of a Rare Case

This case report describes a rare and complex instance of urinary bladder herniation into the scrotal sac, complicated by intrascrotal perforation. This condition, primarily seen in elderly, obese men, poses significant diagnostic and therapeutic challenges. The patient, an 83-year-old man with a history of obesity and chronic lower urinary tract symptoms, presented with acute scrotal pain and swelling. Physical examination revealed a tender, enlarged scrotum with a palpable mass. Imaging studies, including ultrasound and computed tomography, confirmed bladder herniation into the scrotal sac with evidence of perforation. Prompt surgical intervention involved partial cystectomy to remove the perforated segment of the bladder and repair the hernia. The procedure was successful, and the patient experienced an uneventful postoperative recovery with no recurrence or complications. Follow-up assessments showed a return to normal urinary function. This case underscores the critical importance of timely diagnosis and intervention in managing such rare and potentially life-threatening conditions, particularly in elderly, obese males presenting with scrotal swelling and pain.