Unexpected Ureter Within an Inguinal Hernia

Inguinal hernias containing a ureter are a rare occurrence. They are rarely diagnosed pre-operatively and can lead to serious complications if inadvertently damaged during hernia repair. We present the case of a 36-year-old obese male who was found to have a ureter within his inguinal hernia intra-operatively. Due to imaging performed at another hospital, we have both pre and post-operative imaging demonstrating the ureter, its course into the inguinal hernia and its subsequent reduction back into the retroperitoneal space. We discuss the epidemiology of this phenomenon, the clinical implications and methods that have been suggested for pre-operative diagnosis.