A Case of Giant Inguinal Hernia that Caused Postrenal Kidney Dysfunction Repaired by Transabdominal Preperitoneal Repair

Abstract

An 83-year-old man visited our hospital because of difficulty urinating and a huge right scrotum that had started enlarging one month earlier. The scrotum reached the middle point of the thigh, and an irreducible giant inguinal hernia was diagnosed. Computed tomography showed that the right inguinal hernia contained a part of the small intestine, and the bladder, bilateral ureters and renal pelvis were dilated. Serum creatinine levels were elevated. After placement of an indwelling urethral catheter, kidney dysfunction improved. Elective surgery was performed and the hernia orifice and myopectineal orifice were repaired with a transabdominal preperitoneal approach. After the operation, difficulty urinating was improved. Thus, it seemed that the hernia had been compressing the urethra, and surgery relieved the abdominal pressure on the urethra, permitting urination. A giant inguinal hernia associated with difficulty urinating requires early repair.