Unusual case of bladder hernia presenting with abdominal pain

Urinary bladder hernias are rare and often underdiagnosed causes of lower abdominal and groin pain with or without urinary symptoms, particularly in elderly men with urinary symptoms presenting in emergency departments. This case highlights the importance of recognizing bladder herniation as a differential diagnosis in the emergency department for such presentations particularly elderly men with vague lower abdominal pain with or without urinary symptoms. It could also present with or without lump in groin. This case is 39-year-old male presented with chronic lower abdominal and groin pain. Frequency of micturition ultimately diagnosed as an inguinal bladder hernia. Bladder involvement occurs in 1–4% of inguinal hernias, though preoperative diagnosis remains rare (≤7%) due to non-specific symptoms. This case underscores the importance of considering bladder herniation in patients with known hernias who develop urinary symptoms or persistent pain. Computed tomography (CT) cystogram confirmed the diagnosis, and open hernioplasty with mesh repair resolved symptoms without recurrence. Early recognition and tailored surgical intervention prevent complications like obstruction or strangulation.