[An unusual cause of ureteral obstruction in kidney transplant]

Inguinal herniation of the ureter in a kidney transplantation is a rare cause of late distal ureteral obstruction. Herniation is usually secondary to the implant of a long redundant ureter and to its course on the spermatic cord. This clinical condition can worsen graft function in the presence of ipsilateral hydroureteronephrosis. In this review, we describe the case of an asymptomatic 51-year-old man with a history of right iliac renal allotransplantation 12 years before. Kidney ultrasound showed moderate hydroureteronephrosis and ureteral kneeling at the upper third of the inguinal canal. The patient presented a mild increase in serum creatinine; physical examination revealed an ipsilateral inguinal hernia. A CT scan of the abdomen with no contrast medium confirmed middle-distal ureteral kneeling engaging in the sac of the right inguinal hernia. The patient underwent surgical hernia repair with no complications and his renal function recovered completely.