Obstructive uropathy after inguinal herniorrhaphy with a mesh in a renal transplant patient

Area of Science:

• Nephrology
• Urology
• Surgical Oncology

Background:

• Inguinal hernias are common surgical conditions.
• Renal transplant recipients are at increased risk for complications.
• Hernia repair, particularly with mesh, can lead to rare but serious complications.

Purpose of the Study:

• To report a case of acute renal failure secondary to ureteral obstruction after inguinal hernia repair.
• To highlight the diagnostic and management strategies for this rare complication.

Main Methods:

• A case report of a 67-year-old male renal transplant patient.
• Diagnosis of indirect inguinal hernia and subsequent acute renal failure.
• Management involved hemodialysis, percutaneous nephrostomy, mesh removal, and ureteral stent insertion.

Main Results:

• The patient developed acute renal failure post-herniorrhaphy with mesh.
• Computed tomography revealed hydronephroureter with distal ureteral obstruction.
• Percutaneous nephrostomy and ureteral stenting led to recovery of renal function.

Conclusions:

• Ureteral obstruction is a potential complication of inguinal hernia repair, especially with mesh.
• Early recognition and intervention with nephrostomy and mesh removal are crucial for renal recovery.
• This case underscores the importance of considering urinary tract complications in post-operative renal transplant patients.