Inguino-Ureteral Hernia: A Rare Diagnostic Challenge

Inguino-ureteral hernia is an extremely rare condition that is difficult to diagnose and often identified intraoperatively. There are two anatomopathological types: extraperitoneal and paraperitoneal. When symptomatic, treatment is based on relieving the obstruction, either endoscopically or surgically. We report the case of a 73-year-old male patient admitted to the emergency department for right renal colic. Clinical examination revealed a strangulated right inguinoscrotal hernia. Contrast-enhanced abdominal CT scan showed the aforementioned hernia along with mild ureterohydronephrosis, likely due to ureteral entrapment within the hernia. Surgical management consisted of the reduction of the herniated viscera, including the ureter, followed by hernia repair using the Lichtenstein technique. Our aim is to shed light on this under-recognized entity and to recommend cross-sectional imaging when upper urinary tract symptoms are associated with an inguinal hernia.