A 51-year-old man with pubic pain for 2 weeks with left scrotum swelling and
increasing in size for 6 months. He has to compress the scrotum by hand in order to empty the bladder everytime normal ending of micturition= two-stage micturition: the patient after a first spontaneous voiding, presses the mass and voids again. No other urinary symptoms. There was no history of nausea or vomiting.
Ultrasound scanning detected one sac containing of fluid on the left side of scrotum. This sac with thick wall continued upwards left pubic tubercle and getting smaller like a bird beak. This sac appears bigger when the patient did holding his breath (Valsalva maneuver) and disappered after being compression by hand to voiding.
Retrograde cystography CT revealed a left scrotal hernia with fluid density lesion continuous with left lateral bladder wall.
Diagnosis of left scrotal hernia with bladder as content was made.
Have you ever seen a case like that before and what do you think?