Inguinal hernia causing extrinsic compression of bilateral ureters leading to chronic obstructive uropathy

Grice, Peter; Nkwam, Nkwam

doi:10.1093/jscr/rjy062

Cited by 5 publications

(7 citation statements)

References 8 publications

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“…Although there have been numerous cases of obstructive uropathy caused by ureteral inguinal hernias, the obstructive uropathy in our case was instead due to the unilateral external compression by the hernia sac on the ureter. In the only other reported case of ureteric compression by a hernia sac, the patient had an inguinoscrotal hernia that contained the colon, differing from the findings in our patient [ 3 ]. The distal ureter of our patient became entrapped within the mesentery at the communication point between the peritoneal cavity and retroperitoneum.…”

Section: Discussioncontrasting

confidence: 99%

“…These severe complications can be detected and repaired swiftly. In some instances, the ureter may become entrapped in the hernia sac, causing a ureteral obstruction that resolves after hernial repair [ 3 ]. Herein, we describe the case of an 86-year-old man who initially presented with sepsis secondary to a urinary tract infection (UTI).…”

Section: Introductionmentioning

confidence: 99%

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Hernia Causing Ureteral Obstruction With Hydronephrosis and Subsequent Urinary Tract Infection and Sepsis

Healey¹,

Rifai²,

Maqueira³

et al. 2022

Cureus

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Inguinal hernias are common anatomic defects, especially among men. Complications of inguinal hernias include incarceration, but incarcerated hernias rarely cause other disturbances. An 86-year-old man with a history of chronic kidney disease (stage IIIb) presented with recurrent urinary tract infections and acute kidney injury with sepsis. Physical examination revealed a right inguinal hernia, and non-contrast abdominal computed tomography revealed right ureteral obstruction and distal entrapment by the inguinal hernia, with hydronephrosis. The patient underwent right retrograde pyelography and ureteral stent placement, followed by laparoscopic inguinal herniorrhaphy with mesh, which restored renal function. Our case is unique among obstructive uropathies due to inguinal hernias because the distal ureter was entrapped within the bowel mesentery communicating between the peritoneal cavity and retroperitoneum. Both inguinal hernias and obstructive uropathy are common among elderly men. While the latter is often secondary to prostate malfunction, other causes of obstructive uropathy or hydronephrosis should be considered, especially if unilateral.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Hernia Causing Ureteral Obstruction With Hydronephrosis and Subsequent Urinary Tract Infection and Sepsis

Healey¹,

Rifai²,

Maqueira³

et al. 2022

Cureus

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“…Reported causes have been extrinsic compression of ureters by the hernial contents, involvement of ureters in the hernial sac, or the presence of the urinary bladder, or its diverticula as contents of the hernial sac causing bladder outlet obstruction. 1 2 3 The present case highlights the importance of lower urinary tract obstruction as a cause for hernia and also points toward the deviation and further obstruction of urethra due to the direct mass effect of the omentum lying in the hernial sacs. Such an effect seems to have occurred by descent of the hernial contents under the Colles' fascia.…”

Section: Discussionmentioning

confidence: 67%

“…Abdominal wall hernias seldom cause obstruction of the urinary tract at the level of ureters and the bladder outlet. 1 2 We are reporting a case of a complex abdominal wall hernia, causing urethral path distortion leading to outflow obstruction in a patient having an old standing urethral stricture.…”

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confidence: 99%

A Rare Case of Complex Hernia Causing Urethral Obstruction

Agrawal

Bagla

2021

Surg J (N Y)

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Abdominal wall hernias rarely cause obstruction of the urinary tract. We present the case of a patient undergoing regular smooth dilatations for urethral stricture since 8 years who developed right inguinoscrotal swelling and narrowing of urinary stream since 2 years of age. There was a growing difficulty in dilatation due to path distortion of urethra by the hernia. He had a history of open suprapubic cystostomy (SPC) 8 years ago. The patient refused surgery till he landed with an inability to pass dilators and difficulty in passing urine. He was taken up for right inguinal exploration with internal optic urethrotomy (IOU). Intraoperatively, he was found to have right inguinal hernia with incisional hernia at the site of SPC which was repaired and a cystoscopy revealed urethral deviation with anterior urethral stricture for which IOU was done. Postoperatively, the patient's urethral tract straightened and his urinary complaints resolved. A complex hernia can cause urethral deviation and obstruction due to pressure effects of its contents and should be repaired at an early stage.

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“…Though some of these patients may present with enlarging scrotum [4], unexplained urinary tract infection, hydroureter, or hydronephrosis [5], they often go undiagnosed until a surgical repair is performed. This presentation certainly increases the intraoperative risk of injury to the ureter with an increased risk of mesh infection if one is placed.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Repair of Extraperitoneal Ureteral Inguinal Hernia With Mesh Placement

Negmadjanov

Daubert

Rawlinson

et al. 2020

Cureus

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Ureteral inguinal hernias are a well-described entity, within the spectrum of sliding hernias, with over 140 cases described since 1880. Though herniation of the ureter is relatively rare and complete ureteric obstruction is infrequent, a massive herniation may cause complete obstruction, leading to hydronephrosis. Management of these hernias is challenging and poses a significant danger of inadvertent injury and entrapment of a tortuous ureter. When faced with this type of hernia, extreme care should be taken to perform the appropriate preoperative workup and thoroughly plan the surgical approach. The present case describes a patient with a known ureteral inguinal hernia, who underwent a laparoscopic repair of the hernia with mesh placement.

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Inguinal hernia causing extrinsic compression of bilateral ureters leading to chronic obstructive uropathy

Cited by 5 publications

References 8 publications

Hernia Causing Ureteral Obstruction With Hydronephrosis and Subsequent Urinary Tract Infection and Sepsis

Hernia Causing Ureteral Obstruction With Hydronephrosis and Subsequent Urinary Tract Infection and Sepsis

A Rare Case of Complex Hernia Causing Urethral Obstruction

Laparoscopic Repair of Extraperitoneal Ureteral Inguinal Hernia With Mesh Placement

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