Ureteroinguinal hernia: Better safe than sorry

A 66-year-old patient presented with voluminous bilateral inguinal hernias of elastic consistency; Abdominal CT was performed to rule out testicular masses. The CT showed bilateral inguinal hernias with fat content and right ureterohydronephrosis due to an atypical and elongated right ureter that was herniated into the scrotal bag (Fig. 1-a). The placement of a ureteral catheter allowed the safe identification of the ureter throughout Lichtenstein-type hernioplasty (Fig. 1b). Subsequent urography showed the ureter still elongated but positioned in the abdominal cavity (Fig. 1c). In complex or atypical inguinal hernias, preoperative CT can avoid surgical iatrogenesis.

Fig. 1

Acknowledgments

We appreciate doctors Eva Barluenga Torres, Anna Colomer, Fernando Agreda and Mauro Bernardello for their participation and collaboration in this case.