Soloviev A E
Ryazan State Medical University, Ryazan, Russia.
Urologiia. 2025 May(2):63-66.
To study the features of the clinical manifestations, diagnosis and treatment of children with bladder hernias.
A total of 8 children with bladder hernias were observed, including five patients with inguinal hernias of the bladder and two with femoral hernias. One girl had a perineal bladder hernia. To verify the diagnosis, clinical and laboratory examinations, ultrasound and Doppler examination of the scrotum, bladder catheterization, cystoscopy and cystography, intravenous urography, CT, and morphological studies of the surgical specimen were used. In this article, we presented four clinical cases.
Difficulties in diagnosing bladder hernias in children, especially when they are incarcerated, are associated with atypical clinical manifestations, which mimic an incarcerated inguinal hernia. In 5 children with inguinal and two children with femoral hernia of the bladder, the diagnosis was not correctly made before the surgical procedure. In two cases, there was bladder damage during intervention. Combined surgical procedure with abdominal and herniotomy approaches allowed to perform radical procedures for both inguinal and femoral hernias of the bladder. A girl with a perineal hernia of the bladder complicated by urolithiasis was undergone to anterior colporrhaphy and posterior colpoperineorraphy with a removal of bladder stones.
Bladder hernias in children are always sliding and are rare. Clinically, bladder hernias in children mimic an incarcerated inguinal hernia. Correct diagnosis of bladder hernias is difficult. No child with inguinal and femoral bladder hernias was correctly diagnosed before surgical intervention. Abdominal and herniotomy approaches can be the method of choice for femoral hernias of the bladder. With perineal hernia of the bladder, anterior colporrhaphy and posterior colpoperineorraphy are indicated.
研究小儿膀胱疝的临床表现、诊断及治疗特点。
共观察8例小儿膀胱疝患者,其中膀胱腹股沟疝5例,膀胱股疝2例。1例女孩为会阴膀胱疝。为明确诊断,采用了临床及实验室检查、阴囊超声及多普勒检查、膀胱插管、膀胱镜检查及膀胱造影、静脉肾盂造影、CT以及手术标本的形态学研究。本文介绍了4例临床病例。
小儿膀胱疝尤其是嵌顿性膀胱疝的诊断困难,与不典型的临床表现有关,这些表现类似嵌顿性腹股沟疝。5例膀胱腹股沟疝和2例膀胱股疝患儿在手术前均未得到正确诊断。2例在干预过程中出现膀胱损伤。采用腹部和疝修补术联合的手术方法可对膀胱腹股沟疝和膀胱股疝进行根治性手术。1例膀胱会阴疝合并尿路结石的女孩接受了阴道前壁修补术和阴道后壁会阴修补术,并取出膀胱结石。
小儿膀胱疝多为滑动性疝,较为罕见。临床上,小儿膀胱疝类似嵌顿性腹股沟疝。正确诊断小儿膀胱疝困难。在手术干预前,没有1例膀胱腹股沟疝和膀胱股疝患儿得到正确诊断。腹部和疝修补术可作为膀胱股疝的首选治疗方法。对于膀胱会阴疝,应行阴道前壁修补术和阴道后壁会阴修补术。