Kim Yeong Uk, Cho Jae Ho, Song Phil Hyun
Department of Urology, Yeungnam University Hospital, Daegu, Korea.
Department of Radiology, Yeungnam University College of Medicine, Daegu, Korea.
Yeungnam Univ J Med. 2020 Oct;37(4):337-340. doi: 10.12701/yujm.2020.00402. Epub 2020 Jul 29.
Ureterosciatic hernia is extremely rare. In ureteral herniation, ureter prolapses occur through either the greater or lesser sciatic foramen. Atrophy of the piriformis muscle, hip joint diseases, and defects in the parietal pelvic fascia are predisposing factors for the development of ureterosciatic hernia. Most symptomatic patients have been treated surgically, with conservative treatment reserved only for asymptomatic patients. To the best of our knowledge, long-term follow-up outcomes after ureterosciatic hernia management are sparse. In this paper, we report the case of a 68-year-old woman who presented with colicky left abdominal pain. After computed tomography (CT) scan and anterograde pyelography, she was diagnosed ureterosciatic hernia with obstructive uropathy. We performed ureteral balloon dilatation and double-J ureteral stent placement. After this minimally invasive procedure, CT scan demonstrated that the left ureter had returned to its normal anatomical position without looping into the sciatic foramen. The patient remained asymptomatic with no adverse events 7 years after the minimally invasive procedures. This brief report describes ureterosciatic hernia successfully managed with minimally invasive procedures with long-term follow-up outcomes.
坐骨输尿管疝极为罕见。在输尿管疝形成过程中，输尿管通过坐骨大孔或坐骨小孔脱出。梨状肌萎缩、髋关节疾病以及盆腔壁层筋膜缺损是坐骨输尿管疝发生的易感因素。大多数有症状的患者接受了手术治疗，保守治疗仅适用于无症状患者。据我们所知，坐骨输尿管疝治疗后的长期随访结果很少。在本文中，我们报告了一例68岁女性，她出现左侧腹部绞痛。经计算机断层扫描（CT）和顺行肾盂造影检查后，她被诊断为坐骨输尿管疝伴梗阻性尿路病。我们进行了输尿管球囊扩张和双J输尿管支架置入术。在这个微创手术后，CT扫描显示左输尿管已恢复到正常解剖位置，未再疝入坐骨孔。在微创手术7年后，患者仍无症状，未出现不良事件。本简短报告描述了通过微创手术成功治疗坐骨输尿管疝并获得长期随访结果的情况。
