title: Inguinal hernia containing bladder and ureteroneocystostomy: a rare cause for acute renal graft dysfunction.
abstract: A 77-year-old man presented with acute graft dysfunction 25 years after a renal transplant in the left iliac fossa. He also had an asymptomatic left inguinal hernia. Renal ultrasound showed a significant pyelocalicial dilation of the kidney graft and the patient was submitted to a percutaneous nephrostomy. An antegrade nephrostogram was performed, which showed a dilated ureter and the bladder included in the left inguinal hernia that caused the obstructive uropathy. Concomitant retrograde cystography also showed a significant portion of the bladder in the hernia sac. The patient was submitted to inguinal hernia repair, which resolved the obstruction. We present a rare and potentially curable cause of obstructive uropathy in a transplant recipient; it is possible to revert graft dysfunction and prevent graft loss if the condition is recognised early.
authors.affiliation: Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Hugo
authors.initials: H
authors.lastname: Coelho
authors.affiliation: Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Nunes
authors.affiliation: Serviço de Cirurgia B, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Carolina
authors.initials: C
authors.lastname: Canhoto
authors.affiliation: Serviço de Urologia e Transplantação Renal, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Temido
mesh_terms: D000368:Aged; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D016896:Treatment Outcome