Category: Other, Miscellaneous
Introduction & Objective : Sciatic herniation of ureter is rarely reported and there were only case reports before. Some risk factors including hip joint disease, neuromuscular disease or muscle wasting were identified. Here we introduce two cases diagnosed with ureteric sciatic hernia in single center in Taiwan.
Methods : We retrospectively reviewed history and image of these two cases. First one is 59-year-old woman without systemic disease presented with colicky left lower abdominal pain; another is 74-year-old woman with history of Wegener granulomatosis suffering fever, nausea, vomiting, and left flank-knocking pain. Two cases both showed pyuria on urinalysis. Regarding the first case, computed tomography without contrast medium revealed a left ureteric sciatic hernia and left hydroureteronephrosis. As for the second case, urodynamic antegrade pyelography confirmed dilated left ureter with herniation of the ureter into the sciatic foramen.
Results : These two hernias were successfully corrected with improvement of associated symptoms. Two different operative managements included double-J stent placement by assistance of semi-rigid ureteroscopy and a guidewire and laparoscopic repair, respectively.
Conclusions : Although few case of ureteral sciatic hernia was noted before. Dignostic tools including IVP, CT or antegrade pyelography can demonstrate the route of ureter successfully. Treatment including double-J placement, laparoscopic repair or open method was reported. In our cases, endoscopic surgery and laparoscopic repair were done successfully.
National Cheng Kung University Hospital
Tainan, Tainan, Taiwan (Republic of China)