Inguinal cystoceles: A previously overlooked etiology of prostatism in men without bladder outlet obstruction

Hiromi Kumon, Hideo Ozawa, Teruhiko Yokoyama, David A. Rivas, Toyohiko Watanabe, Michael B. Chancellor

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Purpose: We determine whether inguinal cystoceles, a type of extraperitoneal herniation of the bladder, are responsible for symptoms consistent with prostatism in men without bladder outlet obstruction. Materials and Methods: From January 1996 to February 1997 inguinal cystoceles were treated with surgical repair of the floor of the inguinal canal in 8 men with a relatively long history of symptoms consistent with prostatism. The diagnosis of inguinal cystoceles was based on the filling phase of video urodynamic studies done with the patient standing. The clinical outcome of surgery was assessed using the International Prostate Symptom Score and urodynamic findings. Results: All inguinal cystoceles studied were physically occult but clearly detected as widemouthed, mild protrusions of the bladder wall in the inguinal region on cystograms obtained with the patient standing. Although clear cystoceles were present on radiography on the right side in 1 case, the left side in 2 and bilaterally in 5, apparent bilateral weakness in Hesselbach's triangle was noted in all at surgery. High detrusor opening pressure and a relatively long opening time were regarded as urodynamic parameters characteristic of this condition. These parameters and subjective symptoms dramatically improved after bilateral surgical repair of the floor of the inguinal canal. Conclusions: Inguinal cystoceles negatively affect voiding dynamics by increasing opening pressure and opening time, indicating that they should be considered in the differential diagnosis of men with symptoms consistent with prostatism. Video urodynamics is mandatory to detect this condition, which to our knowledge has been previously overlooked on radiography and urodynamics.

Original languageEnglish
Pages (from-to)766-771
Number of pages6
JournalJournal of Urology
Volume159
Issue number3
DOIs
Publication statusPublished - Mar 1998
Externally publishedYes

Keywords

  • Hernia
  • Prostatic hypertrophy
  • Prostatism
  • Urination disorders

ASJC Scopus subject areas

  • Urology

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