Abstract
Aim
Ureterosciatic hernia (USH) is an extremely unusual condition, with presentations ranging from asymptomatic, to flank pain, renal failure, septic shock and even obstructive uropathy. Due to its rarity, there are no recommendations on the treatment of USH. We therefore carried out a systemic review of published literature on its management.
Method
The systemic review was completed using three search terms: “uretero sciatic hernia”, “ureterosciatic hernia” and “ureteric sciatic hernia” on Healthcare Databases Advanced Search, producing 224 potential papers. This was narrowed down to 42 papers after using the PRISMA guidelines. All selected papers included a case report of USH, as well as the investigation and management in English only.
Result
We report a case of an 85-year-old female who was investigated for weight lost with Computed Tomography(CT), which showed an incidental finding of USH. She was managed conservatively after she denied any symptoms and had no hydronephrosis. Abdominal pain was the most common presentation of USH(64%), whilst only 9.5% were found incidentally. 79% of all patients had a CT scan which showed the pathognomonic “curlicue” sign. 55% of all patients had hydronephrosis. Half of all patients had surgical intervention, from open repair to laparoscopic to robotic(9.5% of all management)with no known mortality. Conservatively management(16.6%) was reserved for asymptomatic/poor surgical candidates, and were more likely to be followed up compared to surgical patients(55.5%vs47.6%).
Conclusions
Our case is of an incidental USH managed conservatively, with a literature review emphasising similarities to our case and the different management options.
Huge intrameniscal cyst successfully treated by open debridement and combined arthroscopic and open repair: a case report
