 |
Case Report
Uretero-inguinal herniation: A surprise content in the inguinal canal
1 Core Surgical Trainee, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
2 Consultant Urology Surgeon, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
3 Consultant Transplant and HPB Surgeon, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
Address correspondence to:
Jake Vaughan
Core Surgical Trainee, Oxford University Hospitals NHS Foundation Trust, Oxford,
United Kingdom
Message to Corresponding Author
Article ID: 100064Z15JV2026
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Vaughan J, Gietzmann W, Udupa V. Uretero-inguinal herniation: A surprise content in the inguinal canal. J Case Rep Images Urol 2026;11(1):26–29.ABSTRACT
Introduction: Inguinal hernias account for over 75% of abdominal wall hernias, with a global prevalence of 7.7%. While bladder involvement occurs in 1–4% 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.
Keywords: Hydronephrosis, Inguinal hernia, Ureteric obstruction, Uretero-inguinal hernia
SUPPORTING INFORMATION
Acknowledgments
Artificial intelligence (AI) use in the article:
AI is used for formatting. No generative AI is used.
Jake Vaughan - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
W Gietzmann - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
V Udupa - Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 J Vaughan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
