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Ureterosciatic hernia causes obstructive uropathy.

Ping-Ju Tsai¹, Jen-Tai Lin, Tony T Wu

¹Department of Urology [corrected] Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan, ROC.

Journal of the Chinese Medical Association : JCMA

|September 27, 2008

Summary

Ureteral herniation, a rare cause of obstructive uropathy, can occur in the sciatic foramen. This case highlights watchful waiting for asymptomatic elderly patients with this rare condition.

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Area of Science:

Urology
Radiology
Nephrology

Background:

Obstructive uropathy presents diverse etiologies, including urolithiasis, strictures, inflammation, malignancy, and external compression.
Ureteral herniation is an uncommon cause of obstructive uropathy, with the inguinal region being the most frequent herniation site.
Sciatic ureteral herniation is a rare variant, with management strategies varying from observation to surgical intervention based on symptoms and obstruction.

Observation:

A 91-year-old female presented with asymptomatic left hydronephrosis.
Imaging revealed an extremely rare ureterosciatic herniation as the cause of the obstruction.
The patient's global renal function was deemed acceptable, but she was considered a poor surgical candidate due to advanced age.

Findings:

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The patient was diagnosed with asymptomatic hydronephrosis secondary to ureterosciatic herniation.
Conservative management via watchful waiting was chosen due to the patient's age and surgical risk.
This approach was selected after thorough discussion with the patient and her family.

Implications:

This case underscores the importance of considering rare diagnoses like ureterosciatic herniation in obstructive uropathy.
Watchful waiting can be a viable management option for asymptomatic elderly patients with significant comorbidities.
Further research into the long-term outcomes of conservative management for rare ureteral herniations is warranted.