Dikmen Ayse V, Guneri Cagri, Yalcin Serdar, Acikgoz Onur, Ak Esat, Cetiner Sadettin
Urology Clinic, Polatlı Duatepe Government Hospital, Ankara, Turkey.
Urology Clinic, Liv Hospital, Ankara, Turkey.
Curr Urol. 2017 Nov;11(1):51-53. doi: 10.1159/000447194. Epub 2017 Nov 30.
A 74-year-old male patient with prostate cancer under remission was admitted with left inguinoscrotal swelling. He underwent scrotal ultrasound demonstrating a giant in-guinoscrotal hernia. Contrast-enhanced computerized tomography of the abdomen and pelvis demonstrated a left pelvic kidney associated with severe hydroureteronephrosis secondary to a ureteral inguinoscrotal hernia. Upon exploration with left inguinal incision, a paraperitoneal ureteral in-guinoscrotal hernia and a hypertrophic left spermatic cord were observed. The elongated and tortuous left ureter, being pulled down to the scrotum by the hernia, was released from the herniating tissues fullfilling left hemiscrotum. The ureter was tapered followed by ureteroureterostomy. The accompanying left spermatic cord was excessively elongated and curled, necessitating cordectomy. The hernia was repaired with prolene mesh after removal of herniating peritoneal tissue. This is a rare case of a paraperitoneal ureteral inguinoscrotal hernia of the left pelvic kidney.
一名处于缓解期的74岁前列腺癌男性患者因左腹股沟阴囊肿胀入院。他接受了阴囊超声检查,显示为巨大腹股沟阴囊疝。腹部和盆腔的增强计算机断层扫描显示左盆腔肾,伴有输尿管腹股沟阴囊疝继发的严重肾盂输尿管积水。经左腹股沟切口探查,发现腹膜外输尿管腹股沟阴囊疝和肥厚的左侧精索。被疝拉至阴囊的细长迂曲的左侧输尿管从充满左半阴囊的疝出组织中松解出来。输尿管呈锥形,随后进行输尿管输尿管吻合术。伴随的左侧精索过度伸长和卷曲,需要进行精索切除术。在切除疝出的腹膜组织后,用普理灵网片修补疝。这是一例罕见的左盆腔肾腹膜外输尿管腹股沟阴囊疝病例。