# Case Report: Laparoscopic repair of a recurrent, huge, inguinoscrotal vesicoureteral hernia: a case report and review of the literature

## TL;DR

A rare case of a recurrent inguinal hernia involving the urinary system was successfully repaired using laparoscopic surgery.

## Contribution

This case report highlights the successful laparoscopic repair of a complex, recurrent vesicoureteral hernia with detailed pre- and postoperative management.

## Key findings

- Transabdominal preperitoneal repair (TAPP) successfully reduced the herniated bladder and ureter.
- Postoperative imaging confirmed resolution of hydronephrosis and no recurrence after six months.
- Bladder catheter saline infusion and ureteroscopic assistance aided in intraoperative identification of herniated structures.

## Abstract

Inguinal hernia repair is a routine operation. However, it is rare for the organs of the urinary system to prolapse as the contents of the hernia. An 80-year-old obese male with a history of three prior open inguinal hernia repairs presented with a recurrent large scrotal mass and severe right hydronephrosis. Preoperative Computed Tomography urography (CTU) revealed a giant inguinal vesicoureteral hernia involving the bladder and ureter. The patient underwent transabdominal preperitoneal repair (TAPP) with intraoperative identification of herniated bladder-ureter components facilitated by bladder catheter saline infusion and ureteroscopic assistance. Postoperative CTU at 1 week demonstrated complete reduction of herniated viscera and resolution of hydronephrosis. No complications occurred, and 6-month follow-up confirmed sustained recovery without recurrence. This case provides valuable insight into preoperative diagnostic difficulties and the intra- and postoperative management of an inguinal vesicoureteral hernia in a multiple relapsed old man, highlighting the importance of accurate diagnosis and appropriate surgical intervention in the treatment of this disease.