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经前列腺动脉栓塞术间接治疗腹股沟膀胱疝。

Inguinal Bladder Hernia Indirectly Treated With Prostate Artery Embolization.

作者信息

Garfinkel Alec, Tanwar Ashita, Larson Michael C

机构信息

Radiology, HCA Florida Brandon Hospital, Tampa, USA.

Radiology, California Northstate University College of Medicine, Elk Grove, USA.

出版信息

Cureus. 2023 Aug 7;15(8):e43090. doi: 10.7759/cureus.43090. eCollection 2023 Aug.

Abstract

An inguinal bladder hernia (IBH) is an abnormal protrusion of the bladder into the inguinal canal accompanied by a peritoneum sheath that creates the hernia sac. Clinical presentations vary greatly from lower urinary tract symptoms (LUTS) and reduction in scrotal size after voiding to being entirely asymptomatic. Since inguinal bladder hernias are uncommon and often accompanied by varied and nonspecific symptoms, it is challenging to diagnose and rarely included in differentials. Currently, computerized tomography (CT) imaging with contrast or voiding cystourethrography is recommended for diagnosis. There is no consensus on the best treatment for inguinal bladder hernias, with options ranging from laparoscopic repair to catheterization. In this study, we report the case of inguinal bladder hernia in an 86-year-old male presenting with symptoms of recurrent hematuria and two failed voiding trials after a Foley catheter placement from prostatomegaly resulting in bladder diverticula, and IBH. He was treated with prostate artery embolization (PAE) to address LUTS related to benign prostatic hyperplasia (BPH). The resultant decreased prostatic volume resolved his symptoms of IBH, hematuria, and urinary retention.

摘要

腹股沟膀胱疝(IBH)是膀胱经腹膜鞘突异常突入腹股沟管而形成疝囊。临床表现差异很大,从下尿路症状(LUTS)、排尿后阴囊大小缩小到完全无症状。由于腹股沟膀胱疝并不常见,且常伴有各种非特异性症状,因此诊断具有挑战性,在鉴别诊断中很少被考虑。目前,推荐使用增强计算机断层扫描(CT)成像或排尿性膀胱尿道造影进行诊断。对于腹股沟膀胱疝的最佳治疗方法尚无共识,治疗选择从腹腔镜修补到导尿不等。在本研究中,我们报告了一例86岁男性腹股沟膀胱疝病例,该患者表现为反复血尿症状,因前列腺增生导致膀胱憩室并放置Foley导尿管后两次排尿试验失败,诊断为腹股沟膀胱疝。他接受了前列腺动脉栓塞术(PAE)以治疗与良性前列腺增生(BPH)相关的LUTS。前列腺体积减小后,他的腹股沟膀胱疝、血尿和尿潴留症状得到缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b305/10482422/080ea323f07d/cureus-0015-00000043090-i01.jpg

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