Introduction: Inguinal hernias account for over 75% of abdominal wall hernias, with a global prevalence of 7.7%. While bladder involvement occurs in 1andndash;4% of cases, ureteral herniation is rare. Due to non-specific or absent clinical symptoms, uretero-inguinal hernias may remain undiagnosed pre-operatively, posing significant risk of iatrogenic ureteric injury during surgical repair. Case Report: A 68-year-old man presented with recurrent urinary tract infections and lower urinary tract symptoms, with a background of previous transurethral resection of prostate. Renal ultrasound demonstrated a right sided hydronephrosis, and computed tomography (CT) urogram identified a right inguinal hernia containing a loop of the right ureter, resulting in in ureteric obstruction and hydronephrosis. Antegrade and retrograde stenting were not feasible due to degree of angulation and excess ureteric length. He underwent an open mesh repair of hernia was performed where a redundant loop of ureter was identified within the inguinal canal. The ureter was carefully reduced without resection, and mesh repair was completed. Post-operative imaging confirmed complete resolution of hydronephrosis. Conclusion: Uretero-inguinal hernia is a rare but clinically significant cause of hydronephrosis and urinary symptoms. Computed tomography urogram is essential for accurate diagnosis and pre-operative planning, reducing risk of ureteric injury. Early recognition and multidisciplinary management are key to achieve a safe surgical outcome.
Vaughan et al. (Thu,) studied this question.