Laparoscopic surgical treatment of ureterosciatic hernia after repeated recurrence despite conservative treatment: A systematic review

Abstract

Takahiro Hoshino, Takehiro Sejima*, Hideto Iwamoto and Youji Fukumoto

Ureterosciatic hernia is a rare condition in which the ureter prolapses from the foramen sciaticum. Pro- lapsed organs, other than the ureter, include the ovary, small intestine, colon, and bladder. Ureteral sciat- icum hernia is the rarest form of sciatic hernia, and causes ureteral dilation and hydronephrosis, leading to urinary tract infections and renal failure. Treatment options include surgical and conservative treat- ments with ureteral stenting; however, no consensus has been reached. Surgical treatment includes uret- eral anastomosis, uretero-bladder neoanastomosis, and mesh reinforcement of the sciatic foramen. There have been scattered reports of laparoscopic or robot-assisted repair in recent years.

In this Systematic review, we are presenting and discussing a previous case of ureterosciatic hernia treated with laparoscopic surgery after repeated recurrence despite conservative treatment, including a mini-re- view of the literature. Due to the extreme rarity of the condition, an effective and reliable long-term prognosis has not to be established yet. However, early diagnosis and appropriate target of treatment are essential for optimal recovery, especially in multiple recurred cases. During our review of the literature, to the best of our knowledge and effort, we could not find the consensus of best management of ureteros- ciatic hernia. However, surgical treatment is necessary for the case of ureterosciatic hernia that could not be cured through the conservative approach. Due to the extreme rarity of the condition, optimal surgical technique has not been established. In this mini-review, we are also presenting detailed laparoscopic sur- gical procedures to be informative for urological surgeons who will operate similar cases in the future.