Femoral herniation of transplanted ureter after deceased-donor kidney transplantation

Esposito, Matthew A.; Ratnasekera, Ashanthi; Sebastian, Ely M.; Youssef, Nasser

doi:10.1016/j.ijscr.2015.03.026

Cited by 8 publications

(11 citation statements)

References 7 publications

(8 reference statements)

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“…Most of the patients had over five years of kidney transplant , and almost half of them had over ten years of the procedure [5][6][7]11,13,[15][16][17]20,21,23]. Literature does not provide any statistical evidence for the connection between post-operative time and the identification of ureteric-inguinal hernia.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, one could infer that the chronic exposure to certain immunosuppressant could contribute to this illness, as they may interfere with part of the wound healing process. Among the main clinical features related to this anatomic pathology are previous inguinal surgery, inguinal enlargement, and acute loss of graft function [2,3,[8][9][10]12,14,16,17,20,21,23].…”

Section: Discussionmentioning

confidence: 99%

“…The main image methods used for the diagnosis are graft ultrasound, abdominal CT, and nefrography [5][6][7][8][9][10][11][16][17][21][22][23]. In five cases, abdominal magnetic resonance was used for the documentation [3,4,9,12,19].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Ureteral herniation in kidney transplant - Case Report

LMC¹,

SF²,

WF³

et al. 2020

Trends in Transplant

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ureteral herniation in kidney transplant - Case Report

LMC¹,

SF²,

WF³

et al. 2020

Trends in Transplant

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“…Several case studies of allograft hydroureteronephrosis as a result of ureteroinguinal herniation have been reported. Although exceedingly rare, herniation sites other than the inguinal canal have been described . Regardless of site, prompt and accurate diagnosis is imperative to avert the irreversible sequelae of obstructive uropathy as well as inadvertent ureteric injury during hernia repair .…”

Section: Discussionmentioning

confidence: 99%

Inguinal Herniation Containing Bladder, Causing Contralateral Allograft Hydroureteronephrosis—A Case Report and Literature Review

Toit

Kaestner

Muller

et al. 2017

American Journal of Transplantation

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We report the first documented case of an inguinal hernia containing bladder, resulting in contralateral allograft hydroureteronephrosis. A 39-year-old male patient presented with allograft dysfunction, a contralateral inguinoscrotal hernia, and marked hydroureteronephrosis on ultrasound (US). Percutaneous nephrostogram and a retrograde cystogram suggested bladder herniation with incorporation of the contralateral ureteroneocystostomy into the hernia. Paraperitoneal bladder herniation was confirmed at surgery and hernioplasty was performed. Six-week follow-up revealed normal renal function with no sign of hernia recurrence. Despite occurring rarely, transplant ureter or bladder herniation should be considered in the differential diagnosis of hydroureteronephrosis. This case illustrates that the contralateral position of hernia to allograft does not necessarily preclude the hernia as the source of ureteric obstruction.

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“…The definitive treatment was inguinal herniorrhaphy without the need for ureter reimplantation. However, in the case of ureter necrosis, 12 long redundant ureter 8 , 17 or stricture of the ureter, 10 a ureteral resection with reanastomosis, was required.…”

Section: Discussionmentioning

confidence: 99%

First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

Veroux¹,

Ardita

Zerbo³

et al. 2016

Medicine

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Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later.Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter.Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt diagnosis with graft sonography and abdominal computed tomography scan and emergency surgery may avoid the need for nephrostomy and may resolve graft dysfunction more rapidly.

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Femoral herniation of transplanted ureter after deceased-donor kidney transplantation

Cited by 8 publications

References 7 publications

Ureteral herniation in kidney transplant - Case Report

Ureteral herniation in kidney transplant - Case Report

Inguinal Herniation Containing Bladder, Causing Contralateral Allograft Hydroureteronephrosis—A Case Report and Literature Review

First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

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