Seventy-six-year-old woman with an unusual anatomy of the left ureter

We present a case of a 76-year-old woman, who attended with features suggestive of renal colic; however on imaging, she was found to have a right pelvic kidney and a left-sided uretero-sciatic hernia (USH), identified on CT urography (CT urogram). She was managed conservatively as she had a normal renal function and reported no symptoms in follow-up appointments. USH are rare hernias, where the ureter herniates through the sciatic foramen. Patients might present with sepsis in which case they require emergency stenting either anterograde or retrograde or with pain in which a less urgent approach can be followed and plan for surgery. Our literature review only identified a small number of similar cases, and the most successful treatment method for those symptomatic patients who required a procedure was the surgical repair.