Ureterosciatic hernia with pyonephrosis and obstructive uropathy: a case report

Chan, Clara Yc; Lai, Terence Ct; Yu, Chun-sheng; Leung, Clarence Lh; Chan, Wayne Kw; Law, In‐Chak

doi:10.12809/hkmj208542

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…On searching the PubMed database using the keywords “ureterosciatic hernia” or “uretero sciatic hernia,” we identified 30 reported cases of ureterosciatic hernia since 1999, from English-language papers (Table 1 ) [ 1 – 3 , 5 – 31 ]. The median patient age was 75.5 (57–97) years; all were female.…”

Section: Discussionmentioning

confidence: 99%

Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review

et al. 2021

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Background Ureterosciatic hernia is a rare type of pelvic floor herniation that occurs through the sciatic foramen. The resulting ureteral obstruction may lead to hydronephrosis and to further complications including urinary tract infection and urosepsis. There have been 30 reported cases of ureterosciatic hernia. Ureteral stenting and surgical repair have been used as treatment options. Case presentation We report the case of an 86-year-old woman who was transferred to Tokyo Metropolitan Bokutoh Hospital with symptoms of fever and septic shock. Her computed tomography scan revealed left hydronephrosis and deviation of the left ureter into the sciatic foramen; she was therefore diagnosed with a left ureteral sciatic hernia and admitted in our intensive care unit for further treatment with resuscitative fluids, vasopressors, and antibiotics. Following a retrograde insertion ureteral catheter insertion, ureteral incarceration was relieved, and a double-J ureteral stent was placed in situ. Antibiotic treatment was initiated, and the patient’s hemodynamic status gradually improved. Conclusions Although ureterosciatic hernia is a rare disorder, it is associated with serious complications including urinary tract infection with sepsis, which may warrant urgent corrective procedure to relieve the structural obstruction. Treatment may be conservative or surgical, though treatment with ureteral stent placement may be a favorable approach in elderly patients with multiple comorbidities presenting with urosepsis.

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Section: Discussionmentioning

confidence: 99%

Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review

et al. 2021

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“…[1][2][3][4][5][6] Their diagnosis remains a challenge due to the diversity of symptomatology secondary to the different structures reported in such hernias. [1][2][3][4][5][6][7][8][9][10][11] Ovary, ureter, small intestine, colon, diverticulum, neoplasm, omentum, bladder, and a combination of these structures have all been described in reports. Other reported cases describe hernia defects with no intra-abdominal structures involved.…”

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Repair of a Ureterosciatic Hernia with Combined Ureteral Stenting

Fridling

Gontarz

Stein³

et al. 2023

CRSLS

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Pelvic floor hernias represent a rare type of hernia and a rare etiology of pelvic symptoms. The rarest type of pelvic floor hernias are sciatic hernias, which present with a variety of symptoms depending on the hernia contents and location. Many different treatment approaches are described in the literature. A 73-year-old female presented to our outpatient minimally invasive surgery (MIS) clinic with one year of colicky left flank pain. She had previously presented to an emergency department, at which time a computed tomography (CT) scan demonstrated left-sided hydronephrosis in the setting of a left-sided ureterosciatic hernia. She was asymptomatic and had no palpable hernia bulge. An operative repair was offered based on her prolonged symptoms. The patient was brought electively to the operating room with minimally invasive and urological surgeons. A left ureteral stent was placed over a guidewire. A robotic repair was performed with a round piece of biosynthetic mesh, secured in place with fibrin glue. Sciatic hernias are an extremely rare etiology of pelvic symptoms and require a high index of suspicion to identify. Obstructive and neuropathic symptoms may be intermittent, so diagnosis is often made using CT imaging. We report a successful treatment with pre-operative ureteral stenting followed by a robotic repair using biologic mesh secured with fibrin glue fixation. We believe this is a durable repair although acknowledge that longer follow-up is needed to establish the longevity of our treatment modality.

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Ureterosciatic Hernia in Focus: A Narrative Review of the Literature

Mustafa,

Pouzi,

Senada

et al. 2023

Cureus

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Pelvic herniation of the ureter through anatomical musculoskeletal foramina stands out as one of the rarest causes of ureteric obstruction. Historically, most cases have been documented as incidental intraoperative findings. The herniation of the ureter through the sciatic foramen presents as a particularly uncommon variant of this condition, distinguished by its potential to cause life-threatening sepsis or renal failure if not promptly recognized and treated. The diagnostic process remains challenging, attributed partly to the vague initial symptomatology and subtle radiological findings, and second, to the rarity of this condition. This challenge may be further compounded by the lack of a clear description of clinical features and pathways to raise clinician suspicion. In light of these considerations, we conducted this literature review to illuminate this unique cause of obstructive uropathy, aiming to delineate its clinical features and explore common diagnostic and treatment options.

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Ureterosciatic hernia with pyonephrosis and obstructive uropathy: a case report

Cited by 3 publications

References 5 publications

Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review

Urosepsis secondary to ureterosciatic hernia corrected with ureteral stent placement: a case report and literature review

Robotic-Assisted Repair of a Ureterosciatic Hernia with Combined Ureteral Stenting

Ureterosciatic Hernia in Focus: A Narrative Review of the Literature

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