Paraperitoneal herniation of the ureter

Ureteral herniation into the scrotum is rare and often associated with congenital abnormalities or postoperative anatomic changes. A high index of suspicion is needed to avoid intraoperative ureteric injuries. A 50-year-old man with ureteric herniation into an inguinoscrotal hernia reported acute left flank pain and had a history of recurrent urinary tract infections. Contrast-enhanced computed tomographic evaluation revealed a left ureter extending from the pelvis into the scrotum through the inguinal canal. Screening ultrasound of the scrotum revealed the intrascrotal extension of the ureter along with the other hernial contents and diagnosed as a Paraperitoneal inguinal herniation of the ureter. Various cross-sectional imaging modalities, including Ultrasound, provide good anatomic details that can diagnose the presence of a herniated ureter.