Lesión ureteral inadvertida durante hernioplastia inguinal primaria: grave evento adverso

Introduction: Ureteral injury is a rare clinical entity that causes grave consequences. Its most frequent mechanism of production is iatrogenesis during the course of a surgical intervention. Case report: Present a case of a 63-year-old boy after right inguinal hernioplasty, on the 9th postoperative day, he went to the emergency room due to poor clinical evolution. A CT scan of the abdomen and skin was performed, which detected leakage of urine from the distal ureter. With the diagnosis of the distal right ureteral surgical injury, the surgical intervention for the reimplantation of the ureter was answered, 2 months after the event. Discussion: When the ureter injury occurs during the surgery of the inguinal hernia, it is a failure in the identification of the ureter in the content of an inguino-scrotal hernia. They tend to be large hernias with sliding of intraperitoneal structures. When the inguino-scrotal hernias are appreciated, to prevent this event, an ultrasound or a CT scan should be performed. During surgery, if the presence of an ureter is suspected, identification and simple retroperitoneal repositioning of the ureter is important. Inadvertent lesions may be suspicious in the postoperative period of the clinic and the diagnosis of intravenous or ascending skin combined with echographic or CT techniques. Its management involves the drainage of collections, nephrostomy if necessary and, after stabilization of the patient, ureteral reimplantation.