Asymptomatic herniation of ureter in the routine inguinal hernia: A dangerous trap for general surgeons

Abstract

HighlightsNo inguinal hernia repair is routine.Entrapment of ureter in the inguinal canal is a rare possibility with indirect sliding hernias.Preoperative imaging is warranted in select patients, including those with renal impairment.

Obstructive uropathy secondary to ureteral inguinoscrotal hernia

“…Inguinoscrotal herniation (ISH) of the ureter is extremely rare, even more on native kidneys ( 1 ). ISH is common in 50-60 years old men and frequently associated with pelvic kidney ( 2 ).…”

“…This condition usually has an asymptomatic course unless ureteral obstruction causes pain, infections or renal dysfunction ( 1 , 3 ), signs that indicate ISH should be considered. Computed tomography scan helps to delineate the course of the ureter ( 3 ).…”

“…Computed tomography scan helps to delineate the course of the ureter ( 3 ). Treatment modalities consist of surgical repair ( 1 – 3 ).…”

Inguinal ureter herniation evaluated with magnetic resonance imaging: a case report

“…The possible etiology of this condition is ureter redundancy, probably due to acquired nephroptosis. Finally, the awareness of ureteral herniation into the inguinal canal is critical for the emergency physician to formulate the correct diagnosis to avoid potential ureteral damage in case of surgical repair [ 1 , 6 ]. To the best of our knowledge, this case represents the first experience of inguinoscrotal herniation of the ureter documented by Uro-MRI and, in particular, evaluated by the FIESTA sequence.…”

“…Inguinoscrotal herniation of the ureter (native or transplanted) is an extremely rare medical condition [ 1 ], usually related to congenital abnormalities or to postoperative anatomical alterations [ 2 ]. Most (80%) ureteral inguinal hernias are paraperitoneal, meaning that an anteromedial hernial sac is present with the ureter that is drawn into the canal along the posterior aspect of the peritoneum, while some 20% of cases of ureteral inguinal hernias are extraperitoneal, meaning that a true hernial sac is not present and the ureter is accompanied by retroperitoneal fat only.…”