急性腎後性腎不全により両側尿管ステント留置が必要となった 両側水腎症を伴う膀胱ヘルニアの 1 例.

An 88-year-old man had previously undergone surgical repair for bilateral inguinal hernias and a left femoral hernia. He visited our emergency unit complaining of right inguinal distension and voiding disturbance. Blood tests showed acute renal failure and Radiographic imaging showed bilateral hydronephrosis associated with protrusion of the intestine and bladder into the inguinal region. We considered the cause to be a recurrence of the right inguinal hernia, resulting in acute postrenal failure. Manual replacement was performed to reduce the bulge, with disappearance of voiding disturbance. Surgical repair was scheduled for a later date. Preoperative ureteral stenting was requested, and bilateral ureteral stenting was attempted. Right ureteral stenting was impossible because it was difficult to identify the ureteral orifice due to severe bladder deformity. Accordingly, we created a right percutaneous nephrostomy, followed by anterograde, thereby achieving ureteral stenting. Radical hernia repair operation was performed later, and the clinical condition proved to be a femoral hernia. Postoperative cystoscopy showed only lateral displacement of the right ureteral orifice, and the bilateral ureteral stents were removed at this point. Imaging after removal of the ureteral stents showed improvement in the position of the urinary tract and bladder, and disappearance of the hydronephrosis. The next day the right nephrostomy catheter was removed. We herein report a case of bladder hernia with hydronephrosis requiring bilateral ureteral stenting due to acute postrenal failure, with some discussion of research papers. [ABSTRACT FROM AUTHOR]