Article Text

Download PDFPDF
Massive inguinal herniation of the bladder with bilateral hydronephrosis, complicated by psychosis
  1. Ned Kinnear1,2 and
  2. Derek Barrry Hennessey3
  1. 1Austin Hospital, Heidelberg, Victoria, Australia
  2. 2St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
  3. 3Mercy University Hospital, Cork, Ireland
  1. Correspondence to Ned Kinnear; ned.kinnear{at}


Massive inguinal herniation of the bladder is rare. This case was made more dramatic by the late presentation and simultaneous psychiatric condition. A man in his 70s was found in his burning house and admitted for smoke inhalation. Initially refusing examination or investigation, on the third day, he was found to have massive inguinal bladder herniation, bilateral hydronephrosis and acute renal failure. After urethral catheterisation, bilateral ureteric stent insertion and resolution of postobstructive diuresis, the patient underwent open right inguinal hernia repair and return of the bladder to its orthotopic position. He also diagnosed with schizotypal personality disorder with psychosis, malnutrition, iron deficiency anaemia, heart failure and chronic lower limb ulcers. Four months later and after multiple failed trial of voids, the patient underwent transurethral resection of prostate with successful resumption of spontaneous voiding.

  • Malnutrition
  • Delusional disorder
  • Acute renal failure
  • Urology
  • Prehospital

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: NK and DBH. The following authors gave final approval of the manuscript: NK and DBH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.