[URETEROSCIATIC HERNIA TREATED BY URETERAL STENT PLACEMENT]

Area of Science:

• Urology
• Medical Case Reports

Background:

• Ureterosciatic hernia is a rare condition potentially leading to ureteral obstruction and subsequent complications like pyelonephritis.
• Prompt diagnosis and management are crucial, particularly in elderly patients with comorbidities.

Observation:

• A 95-year-old female presented with symptoms of complicated pyelonephritis, including fever and pyuria.
• Initial CT scan showed mild hydronephrosis; a subsequent scan revealed a ureterosciatic hernia as the likely cause.
• The patient had dementia and was deemed a poor surgical candidate due to advanced age.

Findings:

• Successful management of ureterosciatic hernia with ureteral stent placement was achieved, bypassing the obstruction.
• The patient required repeat stent placement and regular exchange due to recurrent pyelonephritis.
• This approach avoided surgical intervention, considering the patient's age and cognitive status.

Implications:

• Ureteral stent placement is a viable and effective conservative treatment for ureterosciatic hernia, particularly in elderly or high-risk surgical patients.
• This case highlights the importance of considering uncommon hernias in the differential diagnosis of upper urinary tract obstruction in the elderly.
• Non-surgical management with ureteral stenting can improve outcomes and quality of life for select patients with ureterosciatic hernia.