Obstructive Uropathy Secondary to an Indirect Extraperitoneal Ureteral Inguinal Hernia

A 60-year-old male with history of hypertension, chronic kidney disease, obesity, obstructive sleep apnea, and gout presented to the emergency department with increased scrotal edema and pain. After multidisciplinary discussion, the decision was made in combination with the patient to move forward w...

Full description

Saved in:
Bibliographic Details
Published in:The American surgeon 2018-08, Vol.84 (8), p.277-278
Main Authors: Allen, Ahkeel, Cauthen, Allison, Ashley, Dennis
Format: Article
Language:English
Subjects:
Atrophy
Edema
Emergency medical services
Hematuria
Hernia
Hernias
Hypertension
Imprisonment
Kidney diseases
Muscles
Obesity
Risk analysis
Sleep
Transplants
Transplants & implants
Urinary tract
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 60-year-old male with history of hypertension, chronic kidney disease, obesity, obstructive sleep apnea, and gout presented to the emergency department with increased scrotal edema and pain. After multidisciplinary discussion, the decision was made in combination with the patient to move forward with right-sided inguinal hernia repair with possible ureteral reimplantation and observation of the left inguinal hernia. Ureteral inguinal hernias most commonly affect middle-aged men.1 As reported by Allam et al.,4 risk factors include obesity and anterior displacement of the ipsilateral ureter from the psoas muscle. Because of the heterotopic location of kidney transplants, these patients are at increased risk for UIH.1 Ureteral inguinal hernias are usually discovered incidentally.1-4 However, they can present with associated hydronephrosis, dysuria, or hematuria.2 A UIH should always be considered when a patient presents with an inguinal hernia and unexplained hydronephrosis or renal failure.1 Many documented case reports also identify urinary tract infections that result from obstructive uropathy in cases of UIH.1 Ureteral hernias are classified based on the presence or absence of an associated hernia sac.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313481808400803