![]() ![]() excessive bleeding (uncommon) – this may require a blood transfusion in severe cases, or possibly further surgery to stop the bleeding.infection of the womb lining (common) – symptoms include a fever, tummy pain, abnormal vaginal discharge and heavy vaginal bleeding.infection of the wound (common) – causing redness, swelling, increasing pain and discharge from the wound.Some of the main risks to you of having a caesarean include: If there's time to plan your caesarean, your doctor or midwife will talk to you about the potential risks and benefits of the procedure. The level of risk will depend on things such as whether the procedure is planned or carried out as an emergency, and your general health. Role of the Shouldice technique in inguinal hernia repair: a systematic review of controlled trials and a meta-analysis.A caesarean section is generally a very safe procedure, but like any type of surgery it does carry a risk of complications. Open mesh versus laparoscopic mesh repair of inguinal hernia. Obstructive uropathy secondary to ureteral herniation in a pediatric en bloc renal graft.įitzgibbons R Jr. ![]() Sliding hernia containing the ureter: a rare cause of graft hydroureteronephrosis: a case report. Inguinal herniation of a transplant ureter: rare cause of obstructive uropathy. Unusual cause of ureteral obstruction in transplant kidney. As in all the other cases, the outcome after surgery was excellent and the kidney graft function was preserved.Ī rare case of obstructive uropathy in renal transplantation: ipsilateral indirect inguinal herniation of a transplant ureter. 7 This procedure would also grant easier access to the graft in the inguinal region if a future surgical intervention is required. 6 Nevertheless, to minimize the risk of infection and the risk of structural compression by a foreign body, the Shouldice technique, an approach without the use of mesh, was chosen to cure the hernia in our case. Hernia repair with the use of mesh has greatly reduced the risk of recurrence. 1 Our patient is the sixth reported case of inguinal hernia causing obstructive uropathy. recently published a case of indirect inguinal herniation of a transplant ureter and a review of the literature regarding these infrequent urologic complications. The most frequent types of hernia found in these reports are inguinal hernias. Obstructive uropathy after renal transplantation caused by ureteral herniation has been reported in the literature. The patient was discharged, and renal allograft function has remained stable after 1 year of follow-up.ĬT scan showing transplant ureter trapped in a left inguinal hernia. Following surgery, the nephrostomy tube was removed, and abdominal ultrasound showed only mild residual hydronephrosis. A few days later, the patient underwent hernia repair with the Shouldice technique under regional anesthesia. After the procedure, the serum creatinine level slowly decreased to the baseline level, and the patient's symptoms resolved. We proceeded to the placement of a percutaneous nephrostomy tube and a ureteral stent. On the non-contrast CT scan, the distal transplant ureter appeared to be trapped in a left inguinal hernia (Figure 2). Abdominal ultrasound showed massive hydronephrosis of the renal allograft (Figure 1). Urinanalysis showed macroscopic hematuria without leukocyturia, and urine culture was negative. The initial blood tests showed a rise in creatinine level from 150 µmol/L (baseline) to 755 µmol/L and leukocytosis. Based on the clinical presentation, nephrolithiasis was suspected. On the initial physical examination, palpation of the graft generated acute pain. He also noted a decrease in urine output but had no systemic symptoms. He had no past history of urinary stones or other urinary tract problem.Īt admission, he complained of paroxysmal abdominal pain at the site of the allograft for the previous 2 days, accompanied by nausea, vomiting, and rectal tenesmus. Since the transplant, he had had suboptimal but stable renal function. He had end-stage kidney disease secondary to focal segmental glomerulosclerosis and had received a deceased-donor renal transplant in August 2000. ![]() Case ReportĪ 52-year-old patient was admitted in October 2008 for lower left abdominal pain and acute renal allograft dysfunction. Here, we present the case of an acute allograft dysfunction due to an inguinal hernia. 1 Herniation of the transplant ureter is a rare event. In renal transplantation, obstructive uropathy of the graft can be caused by several urologic abnormalities including ureteral stricture, stones, and ureterovesical junction obstruction. Inguinal hernia is the most common type of hernia in men. ![]()
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