案例報告: 罕見的輸尿管坐骨孔疝氣併慢性尿頻與尿急的表現

王嘉源、張東平、薛又仁、黃建榮、賴昱維、蕭毅君、李淑文、陳修聖、邱文祥、高國維

台北市立聯合醫院仁愛院區 外科部 泌尿科

A Case Study: Rare ureterosciatic hernia presenting with chronic urinary frequency and urgency

Chia-Yuan Wang, Tung-Ping Chang, Thomas Y. Hsueh, Andy C. Huang, Yu-Wei Lai, Yi-Chun Hsiao, Shu-Wen Li, Shiou-Sheng Chen, Allen W. Chiu, Kuo-Wei Kao

Divisions of Urology, Department of Surgery, Taipei City Hospital Renai branch

Introduction: Ureterosciatic hernia is an extremely rare form of pelvic sciatic hernia, caused by the herniation of the ureter through the greater or lesser sciatic foramen. It has a broad spectrum of symptoms of pain, obstructive urinary symptoms, paresthesia or sciatica. We presented a 73-year-old female with ureterosciatic hernia who was successfully treated with retrograde ureterotomy and ureteral stent placement.

Results: A 73-year-old female with no prior medical history presented with urinary frequency and urgency for three years. Further evaluation with computed tomography urography (CTU) was done, revealing herniation of the left distal ureter through the ipsilateral greater sciatic foramen, along with left-sided hydronephrosis. Ureterosciatic hernia was diagnosed. Thus, the patient underwent a left ureterotomy and retrograde placement of a ureteral stent, which successfully relieved the obstruction and her symptoms relieved. She was scheduled for follow-up renal ultrasound and ureteroscopy three months post-procedure to monitor for any recurrence of obstruction or hydronephrosis.

Conclusions: Ureterosciatic hernia is a very rare disease that can cause serious symptoms such as sepsis or renal failure if left untreated. Therefore, early diagnosis and effective treatment are crucial. This case highlights that the presentation of long-standing urinary frequency and urgency may need further radiological assessment.