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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 72-year-old man complained of right hemiscrotal swelling and pollakisuria which had appeared 3 days after herniorrhaphy. On physical examination, a large mass in the right scrotum did not transmit light nor shrink upon pressure application. The concentrations of blood urea nitrogen and creatinine in the fluid obtained by puncture from the scrotal mass were high. Cystography demonstrated influx of contrast media into the scrotal mass from the bladder. From these findings, diagnosis was made as herniation of the bladder. An operation was performed through inguinoscrotal incision. The herniated bladder, to which peritoneum was laterally adherent, was incarcerated. The hernia ring, which was located medially to the suture line of previous herniorraphy, had strangulated the herniated bladder. The bladder wall was edematous and the mucosa was dark red. These findings suggested that the blood circulation in the herniated bladder had been disturbed for a relatively long time. Resection of the herniated bladder with the adherent peritoneum was performed in addition to hernia repair. Incomplete herniorrhaphy may be one of the causes of herniation of the bladder in our case.
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PMID:[Herniation of the bladder observed 3 days after herniorrhaphy: a case report]. 152 19

Between April 1985 and April 1993, 100 consecutive men underwent lower urinary tract reconstruction after cystectomy. An ileal low pressure reservoir using the Goodwin cup-patch principle was combined with an afferent ileal tubular segment. The early complication rate was 11%, including 2 postoperative deaths due to septicemia. After a median followup of 27 months (range 3 to 96) 14 patients required surgery for late complications (intestinal obstruction, urethral stricture or tumor recurrence, hernia or ureteral stenosis). A total of 32 patients died of metastatic bladder cancer and 7 died of other causes. The functional capacity of the bladder substitute was increased to the desired 450 to 500 ml. after 3 to 12 months, which was paralleled by improving urinary continence. After 1 year 92% of the patients were continent by day and after 2 years 80% were continent at night. Upper tract surveillance with excretory urography, renal ultrasound and serum creatinine estimation has shown 4 left ureteral strictures but not significant upper tract deterioration or ureteral recurrence. Significant reflux was not observed during video urodynamics unless the reservoir was overfilled. During voiding, by outlet relaxation and straining if necessary, the intra-abdominal pressure increase with straining acted equally on the reservoir and ureters. Therefore, unlike voiding with a normal bladder, no isolated intravesical pressure increase occurred and, thus, there was no reflux from the reservoir. The combination of an ileal low pressure reservoir with an afferent isoperistaltic ileal segment and an open end-to-side ureteroileal anastomosis allows for radical cancer surgery with resection of the ureters where they cross the iliac vessels and minimizes the risk of ureteral stenosis. The unidirectional peristalsis of the ureters and the afferent tubular ileal segment seem to protect the upper urinary tract sufficiently. The surgical technique is straightforward and allows for later conversion to an ileal conduit if necessary. The functional results of the bladder substitute are comparable to other similar reservoir techniques, provided that the patients are carefully selected, well rehabilitated and meticulously followed.
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PMID:Experience in 100 patients with an ileal low pressure bladder substitute combined with an afferent tubular isoperistaltic segment. 777 55

For uremic patients on continuous ambulatory peritoneal dialysis who are complicated with peritonitis, hernia or burn out of meticulous procedure, automated peritoneal dialysis (APD) is a new alternative therapy. We started our APD program by continuous cyclic peritoneal dialysis (CCPD) method from October, 1991 and this study included 3 CAPD patients. Our studies showed high dose CCPD was better than CAPD in ultrafiltration and urea clearance with similar weekly creatinine clearance and weekly KT/V urea. During the one year treatment course, there was no signs of fluid overload. We performed once to twice day time exchange by low volume dialysate (1500-1600ml) There was no events of abdomen discomfort due to increase intraabdominal pressure or recurrent hernia in susceptible patient. The decrease in day time exchange frequency obviously reduced patients'loading. One patient changed to high dose CCPD due to underdialysis after stand CCPD therapy. Two patients returned to hemodialysis due to severe peritonitis and technique method, but careful assessment of dialysis adequacy with PET test and KT/V evaluation is mandatory.
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PMID:[Clinical experience of automated peritoneal dialysis]. 785 Jun 57

The bladder is partially involved in 1 to 4% of all inguinal hernias. However, few cases of massive inguinoscrotal herniation of the bladder have been described, all of which have involved unilateral hydronephrosis. We report on a 45-year-old man with incomplete voiding and massively enlarged right scrotum along with elevated creatinine who was found to have massive inguinoscrotal herniation. Preoperative computerized tomography showed bilateral hydronephrosis. Herniorrhaphy was successfully done through an inguinal incision. The left kidney regained normal function with a decrease in creatinine levels. This case is atypical because of the presence of massive inguinoscrotal herniation with bilateral hydronephrosis. Computerized tomography has proved to be a valuable tool in diagnosing such cases. Surgical repair and reduction of hernia can be accomplished through an inguinal incision.
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PMID:Obstructive uropathy secondary to massive inguinoscrotal bladder herniation. 823 May 33

The fundamental objective of dialysis is to maintain the dose of solute clearance and ultrafiltration (UF). When peritoneal dialysis (PD) patients cannot maintain the target dose of clearance [weekly Kt/V > 2.0, weekly creatinine clearance (CCr) > 60 L/1.73 m2], the dialysis dose needs to be increased. But the means of increasing the dose only by PD are limited, especially for patients with UF failure (UFF). Combination therapy--PD with hemodialysis (PD + HD)--is the simplest way to solve the problem. The purpose of PD + HD therapy is to support solute clearance and UF when PD alone cannot meet the necessary targets. Acute and transient dialysis cases should be excluded. The general prescription for PD + HD should be 5-6 days of PD weekly and 1 session of HD weekly. For determine the adequacy of PD + HD, we adopted the equivalent renal clearance (EKR), transforming the PD weekly Kt/V and then evaluating total clearance from both modalities. Of our 238 dialysis patients, 31 (13%) use combined therapy. Except for 1 patient that transferred from long-term HD, all of patients had been on PD for more than 60 months, and were experiencing uremic symptoms after decline of residual renal function. In 12 cases, the problem was lack of solute clearance; in 5 cases, it was UFF. High permeability was involved in 5 cases: 4 after long-term PD and 1 from the start of PD. Poor self-management occurred in 9 cases. Contributing factors included hernia, diaphragmatic intercourse, and severe heart failure with strict fluid control. Among the 31 patients, 8 used HD twice weekly. After combination therapy was started, the dialysis dose increased and body fluids became controllable. As a result, uremic symptoms improved and the patients' quality of life increased.
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PMID:Five years' experience of combination therapy: peritoneal dialysis with hemodialysis. 1240 89

We report a case of a huge inguinal/scrotal bladder hernia presenting as acute renal failure. A 66-year-old man with a large scrotal mass presented with metabolic acidosis and azotemia and was admitted to the intensive care unit. Computed tomography displayed the bladder completely herniated into the scrotum and bilateral hydronephrosis. After stabilization and percutaneous nephrostomy placement, the patient's creatinine markedly improved, and the hernia was repaired. Bilateral ureteral obstruction from a bladder hernia is a very rare event. Computed tomography is rapid and helpful in this situation. Hernia repair can safely be performed after nephrostomy drainage.
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PMID:Acute renal failure resulting from huge inguinal bladder hernia. 1524 57

Obstructive uropathy following renal transplantation is frequently reported. However, ureteral obstruction due to its incorporation in a sliding hernia is a rare event. Herein, we report a case of late graft hydroureteronephrosis secondary to a sliding hernia containing the transplanted ureter. The diagnosis was confirmed with the aid of magnetic resonance urography and antegrade urography. Following hernioplasty, a decrease of serum creatinine level was achieved with significant decompression of the system.
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PMID:Sliding hernia containing the ureter--a rare cause of graft hydroureteronephrosis: a case report. 1525 43

We describe a case of 51-year-old male with fever, abdominal pain and inguino-scrotal hernia. Laboratory examination revealed hypercreatininemia and hyperglycemia, firstly interpreted as diabetic nephropathy. US and CT scan showed a hernia of the bladder into the scrotum. Surgery revealed multiple bladder perforations with peritoneal diffusion of urine. So, hypercreatininemia was caused by peritoneal reabsorption of urea and creatinine, a condition that may be described as "inverted peritoneal auto-dialysis". Surgical reposition and repairment of the bladder led to rapid normalization of serum urea and creatinine. Discharged diagnosis was intraperitoneal rupture of inguino-scrotal hernia of the bladder in patient with recent onset of diabetes mellitus.
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PMID:Hypercreatininemia and hyperglycemia: diabetic nephropathy or "inverted peritoneal auto-dialysis"? 1573 60

Complete and isolated herniation of the urinary bladder is extremely rare, and the consecutive appearance of bilateral urethral obstruction and renal failure is even rarer. We report about a 73 year old male presenting with massive nausea and muscular weakness. On physical examination he showed a giant inguinal hernia with involvement of the entire bladder along with evidence of bilateral hydronephrosis. His serum creatinine and potassium levels were markedly elevated most likely leading to his presenting symptoms of azotemia (nausea) and hyperkalemia (weakness). After transscrotal drainage and decompression of the bladder, a transurethral catheter was inserted. After gaining full renal recovery, the hernia was repaired successfully performing the Lichtenstein procedure.
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PMID:[Subacute weakness of the lower limbs]. 1786 9

We present a rare case of late renal allograft failure from ureteral obstruction resulting from inguinal herniation. A 72-year-old man presented with an elevated creatinine and hydroureteronephrosis of a transplanted kidney on ultrasound. Noncontrast computed tomography demonstrated an inguinal hernia containing ureter, and a nephrostomy tube was placed. The hernia and ureter were temporarily reduced during antegrade stent insertion. Creatinine normalized and we performed inguinal herniorrhaphy with polypropylene mesh. The ureter was not reimplanted. Renal function remained stable after nephrostomy tube removal. Simple herniorrhaphy without ureteral reimplantation may fix the case of ureteral obstruction from inguinal herniation.
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PMID:Inguinal herniation of a transplant ureter: rare cause of obstructive uropathy. 1815 65


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