A Case of Inguinoscrotal Hernia of the Ureter

Abstract

We present a rare case of inguinoscrotal hernia of the ureter. A 14-year-old boy who presented with left scrotal bulging was referred to our hospital. He underwent left hernioplasty at the age of one. He was diagnosed as having hydrocele testis. We performed surgery under general anesthesia. After opening the inguinal canal, we found a loop tubular structure arising from the deep inguinal ring, which clinically appeared to be a ureter. Postoperatively, drip infusion pyelography-computed tomography (DIP-CT) showed an anatomical anomaly of the left ureter that reached the inguinal canal. We noted his medical history of a hernia sac present at the age of one. We diagnosed him as having congenital paraperitoneal inguinoscrotal hernia of the ureter. A ureter in the inguinal canal is an uncommon presentation. Surgeons should keep in mind this entity, which presents preoperative diagnostic difficulties, and should be cautious when they find a thick vas deferens during hernioplasty. This is the first reported case in Japan.