Ureter within a sliding inguinal hernia.

Large sliding inguinal hernias may contain a variety of either intraperitoneal or retroperitoneal anatomical structures. A ureter within a sliding inguinal hernia has been reported rarely. The author presents such a case to alert the unwary surgeon of this possibility and to indicate a successful method of treatment. Pyelography is indicated as a routine preoperative diagnostic procedure in morbidly obese patients with large irreducible inguinal hernias, particularly if the patient complains of frequency or other urinary symptoms. The ureter should be carefully dissected with its blood supply from the sliding tissues and laid back in the retroperitoneal space with resection or reimplantation. The hernia may then be repaired by standard methods. The patient described in the report is well and free of symptoms 10 years after the operation.