Surgical Outcomes of Ipsilateral Inguinal Hernia After Kidney Transplantation

• Published in: Transplantation proceedings 2024-04, Vol.56 (3), p.561-564
• Main Authors: Ishikawa, Hirosuke, Kobayashi, Takashi, Miura, Kohei, Tasaki, Masayuki, Saito, Kazuhide, Takizawa, Kazuyasu, Sakata, Jun, Wakai, Toshifumi
• Format: Article
• Language: English
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2024.02.010

•After kidney transplantation, inguinal hernias occur on the ipsilateral side, and approximately half of them are accompanied by obstruction of the transplanted urinary tract.•Inguinal hernioplasty with graft ureteral obstruction after kidney transplantation can be performed safely.•Ureteral obstruction and renal dysfunction due to an inguinal hernia can recover after inguinal hernioplasty. We aimed to clarify the clinical features and outcomes of ipsilateral inguinal hernias after kidney transplantation. Eleven patients diagnosed with inguinal hernia on the ipsilateral side after kidney transplantation between 2011 and 2022 were analyzed. Clinical data were retrospectively reviewed from the medical records. Eleven patients were included in the analysis (median age, 68 [range, 28-75] years, male, n = 11). The time from kidney transplantation to hernia surgery was 107 (6-393) months. Eight patients had direct-type inguinal hernias. Three had indirect-type inguinal hernias. Hernia contents included the small intestine (n = 5), transplanted ureter and bladder (n = 2), only bladder (n = 1), transplanted kidney, ureter, and small intestine (n = 1), transplanted kidney and small intestine (n = 1), and transplanted ureter (n = 1). Six patients (55%) were diagnosed with urinary tract obstruction due to inguinal hernia. All hernias were repaired using mesh. The plug method was used in 9 cases. The Lichtenstein method was used in 2 cases. The median operative time was 110 (73-155) minutes, and the median blood loss was 3 (1-85) mL. The median postoperative hospital stay was 4 (2-7) days. In the 6 patients with urinary obstruction, the serum creatinine levels improved (P = .028), and the transplanted urinary tract obstruction disappeared after surgery. There was no recurrence of inguinal hernia. One patient experienced chronic pain in the groin area (Clavien-Dindo grade II) during follow-up. Surgical intervention for inguinal hernia after kidney transplantation is safe and effective for preventing worsening of the kidney graft function.