Scrotal extraperitoneal ureteroinguinal hernia with a horseshoe kidney

Auld, Michael; Gallagher, Kylie; Ali, Ahmad Nurfahmi Akhtar

doi:10.1111/ans.13983

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…Here, the radiologists were able to diagnose the extraperitoneal type clearly and suggested further surgical intervention to resolve the cause of recurrent urinary tract infections, but the outcome of this patient remains unknown. In 2017 a 78 years old male was admitted to the ICU with septic shock after complaining of urinary symptoms [ 72 ]. Considering he was observed as having a massive inguinal hernia on clinical examination, a CT scan uncovered a horseshoe kidney and the left ureter descending in the scrotum, with a stone obstructing the vesicoureteric junction.…”

Section: Discussionmentioning

confidence: 99%

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

et al. 2022

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Although inguinal hernia repair is one of the most common surgical procedures, finding a retroperitoneal structure, such as the ureter, is a rather rare occurrence. Ureteroinguinal hernias may arise in the presence or absence of obstructive uropathy, the latter raising difficulties in diagnosis for the general surgeon performing a regular inguinal hernia surgery. This study aims to collect the relevant literature describing the diagnosis and management of ureteroinguinal hernias and update it with a case encountered in our clinic. The following study was reported following the SCARE guidelines. The relevant literature describes less than 150 cases of ureteroinguinal hernias overall, considering the 1.7% prevalence of inguinal hernias in the general population. With only 20% of these hernias being described as extraperitoneal, such an encounter becomes an extremely rare finding. Our clinical experience brings a case of a 75-year-old male with frequent urinary tract infections and a large irreducible inguinoscrotal hernia of about 20/12 cm located at the right scrotum. The patient underwent an open inguinal hernia repair technique under general anesthesia, incidentally finding an extraperitoneal ureteral herniation. Segmental ureterectomy was performed with uneventful recovery. Intraoperatively, finding an incidental ureteroinguinal hernia raises concerns about probable urinary tract complications during regular hernia repair surgery and whether the diagnosis is likely to happen prior to surgical intervention. Although imaging is rarely indicated in inguinal hernias, the case reports show that a pelvic CT scan with urography in symptomatic patients with urinary symptoms will provide accurate confirmation of the diagnosis. The relevant literature is limited due to the rarity of respective cases, thus making standardized management of such cases unlikely.

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Section: Discussionmentioning

confidence: 99%

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

et al. 2022

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“…It is considered congenital due to anomalies in the development of the Wolffian ducts; they do not have a peritoneal sac but have retroperitoneal fat content [6,13]. The latter has a relationship of up to 46% with urinary tract abnormalities such as crossed renal ectopia, nephroptosis, and horseshoe kidney [2,13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Figure 6 presents a diagnostic algorithm adapted from Yahya et al [1]. Classical imaging findings include the "loop the loop" sign on pyelogram and the "fish hook" sign on abdominal computed tomography (CT) [1,11,14]. Some recognized risk factors for ureteral inguinoscrotal hernias are male sex, obesity, collagen synthesis defects, and a history of kidney transplantation [2,3].…”

Section: Discussionmentioning

confidence: 99%

Obstructive uropathy secondary to a ureteral paraperitoneal inguinoscrotal hernia in a patient with a pelvic ectopic solitary kidney and malrotation: a case report and review of the literature

et al. 2021

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Background Ureteral inguinoscrotal hernias (UISH) are rare, associated in some cases with congenital abnormalities of the urinary tract. Their presentation is commonly asymptomatic, and diagnosis is mostly incidental. Case presentation A 65-year-old male patient presented to the emergency room with neurologic symptoms and an altered renal function. Further investigation revealed a ureteral paraperitoneal inguinoscrotal hernia with a pelvic ectopic solitary kidney and malrotation. Three days after hernia repair and placement of a ureteral JJ stent, the creatinine levels stabilized, and the patient was discharged. Conclusion This is the first reported case of a ureteral paraperitoneal inguinoscrotal hernia in a patient with a pelvic ectopic solitary kidney and malrotation. Currently, it is also the only case reported that has been managed by laparoscopy.

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Scrotal extraperitoneal ureteroinguinal hernia with a horseshoe kidney

Abstract: Fig. 3. Intraoperative retrograde pyelogram showing a tortuous left ureter travelling inferiorly.

Cited by 2 publications

References 4 publications

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

Difficulties in Diagnosing Extraperitoneal Ureteroinguinal Hernias: A Review of the Literature and Clinical Experience of a Rare Encounter in Acute Surgical Care Settings

Obstructive uropathy secondary to a ureteral paraperitoneal inguinoscrotal hernia in a patient with a pelvic ectopic solitary kidney and malrotation: a case report and review of the literature

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