Learning Radiology xray montage

Urinary Bladder Hernias


General Considerations

  • About 1-3% of inguinal hernias involve urinary bladder
  • Femoral hernias are more common in women, inguinal in men
  • More often on right side
  • Small portion to almost all of bladder may herniate
  • Damage during a herniorrhaphy can occur making imaging an important study prior to surgery
  • Contributing factors to developing a bladder hernia include
    • Chronic outlet obstruction and prolonged bladder distension
    • Loss of bladder tine
    • Pericystitis
    • Obesity
    • Space-occupying pelvic masses

Clinical Findings

  • Most are asymptomatic
  • Dysuria
  • Frequency
  • Urgency
  • Nocturia and hematuria
  • Inguinal “mass” which may empty after voiding

Imaging Findings

  • Findings are the same regardless of the imaging modality
    • CT is best for showing overall anatomy of the hernia
  • Wide-mouthed, rounded protrusion of the bladder inferiorly, anteriorly  and laterally
  • Asymmetric bladder
  • The hernia may be less evident or not seen on supine imaging; it may become visible only after voiding

Differential Diagnosis

  • In infants, small protrusions from the base of the bladder laterally are called “bladder ears” and are considered normal


Classification of Bladder Hernias




Most Frequent; extraperitoneal portion of hernia lies along medial wall of sac



covered by peritoneum


Bladder herniates without

any relation with the peritoneum


 bladder hernia

Bladder Hernia. There is contrast in the urinary bladder (bladder). A smooth protrusion points inferiorly through the right inguinal canal (white arrows) into the right groin (hernia).

Imaging of Urinary Bladder Hernias. LE Bacigalupo, , M Bertolotto,, F Barbiera,, P Pavlica, R Lagalla , RS. Pozzi Mucelli and LE. Derchi. AJR 2005;184:546–551