LAUSR

The aim of this communication is to present an exceptionally rare type of hernia and its surgical management. We report the case of a 66-year-old male with recurrence of inguinal hernia. A routine Computed Tomography scan revealed as an incidental finding the ureter forming a loop within the hernia sac. Additional findings included pyelocaliceal duplicity and ureteropelvic dilatation. An attempted transabdominal peritoneal repair (TAPP) was performed, with dissection of the ureter. To prevent adhesion formation with the ureter, no mesh was placed. An inguinal incision and suture of the deep inguinal ring was performed. The patient was discharged the same day, with no associated complications. Ureteroinguinal hernia is a rare presentation, but with potentially serious complications. Knowledge of its existence is important in view of the possibility of its incidental finding. There are approximately 140 cases described in the literature, the vast majority of which involve ectopic kidney. Our case presented an inguinoureteral hernia on native kidneys and obstructive voiding symptoms. The laparoscopic TAPP approach allows identification and safe dissection of the ureter. Due to the low frequency of this pathology, there is no consensus on the placement of the mesh in the peritoneal space due to the risk of adhesion of the ureter. Therefore, in our case we opted for an open repair of the hernia.