PMC7748886_01
The images of case 1 showing the bladder in the right inguinal hernia. (a) Axial CT sections illustrate a small portion of the urinary bladder protruding into the bilateral inguinal canal with a "Mickey mouse"-like appearance. (b) Cystography shows the inverse "Mickey mouse".
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Computed tomography (CT) for PCa staging incidentally revealed bilateral inguinal hernias with the bladder protruding anteroinferiorly on both sides without metastasis (Figure 1(a)). Cystography showed the same "Mickey mouse" phenomenon with the bladder protruding into bilateral hernias mimicking the ears and the rest of the bladder resembling the face (Figure 1(b)).
Intraoperative appearance of the herniated bladder in case 1. (a) Herniated bladder. (b) Spermatic cord. (c) Polypropylene mesh.
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Second, bilateral inguinal hernia repairs were performed using bilateral inguinal incisions that extended medially to the pubis (Figures 2(a) and 2(b)).
PMC7748886_02
Images of case 2 showing the bladder in the right inguinal hernia. (a) Axial MRI image: the arrow indicates the IBH. (b) Coronal CT image: the arrow indicates the IBH. (c) BS image: the arrow indicates the IBH. BS: bone scintigraphy; MRI: magnetic resonance imaging; CT: computed tomography; IBH: inguinal bladder hernia.
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His CT, magnetic resonance imaging (MRI), and bone scintigraphy (BS) demonstrated a right IBH without metastasis (Figures 3(a)-3(c)).