Acute renal failure resulting from huge inguinal bladder hernia

We report a case of a huge inguinal/scrotal bladder hernia presenting as acute renal failure. A 66-year-old man with a large scrotal mass presented with metabolic acidosis and azotemia and was admitted to the intensive care unit. Computed tomography displayed the bladder completely herniated into the scrotum and bilateral hydronephrosis. After stabilization and percutaneous nephrostomy placement, the patient's creatinine markedly improved, and the hernia was repaired. Bilateral ureteral obstruction from a bladder hernia is a very rare event. Computed tomography is rapid and helpful in this situation. Hernia repair can safely be performed after nephrostomy drainage.