{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T07:19:33Z","timestamp":1765783173067,"version":"3.48.0"},"reference-count":30,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,11,26]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Ureterosciatic herniation is a rare cause of ureteral obstruction. A bilateral presentation is especially uncommon. We present a female patient in her late 80s diagnosed with bilateral ureterosciatic herniation. She presented with 24 hours of severe left flank and suprapubic pain. A CT scan of the abdomen\/pelvis revealed moderate to severe left-sided hydronephrosis and hydroureter, and a laterally coursing distal left ureter. Retrograde pyelograms revealed bilateral \u2018curlicue sign\u2019 pathognomonic for ureterosciatic herniation with left-sided hydronephrosis. Management required left percutaneous nephrostomy (PCN), which was later converted to percutaneous nephroureteral stent (PCNU). The patient elected for routine left PCNU exchanges every 3 months. Bilateral ureterosciatic herniation is an exceptionally rare cause of ureteral obstruction. Retrograde pyelograms are diagnostic. Initial management achieves renal decompression and hernia reduction with a ureteral stent or PCN\/PCNU. Surgical correction offers definitive repair. For patients not amenable to surgery or ureteral stent exchanges, routine PCNU exchanges are a reasonable approach for management.<\/jats:p>","DOI":"10.1136\/bcr-2025-268459","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T07:15:20Z","timestamp":1765782920000},"page":"e268459","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Management of bilateral ureterosciatic herniation with unilateral symptoms"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9927-8400","authenticated-orcid":false,"given":"Justin Vincent","family":"Nguyen","sequence":"first","affiliation":[{"name":"Urology, UMass Chan Medical School, TH Chan School of Medicine, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Diaz Rubayo","sequence":"additional","affiliation":[{"name":"Urology, UMass Chan Medical School, TH Chan School of Medicine, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Fantasia","sequence":"additional","affiliation":[{"name":"Urology, UMass Chan Medical School, TH Chan School of Medicine, Worcester, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,14]]},"reference":[{"key":"2025121423150996000_18.12.e268459.1","article-title":"Ureterosciatic Hernia in Focus: A Narrative Review of the Literature","volume":"15","author":"Mustafa","year":"2023","journal-title":"Cureus"},{"key":"2025121423150996000_18.12.e268459.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1952.72930220001010"},{"key":"2025121423150996000_18.12.e268459.3","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3109\/00016924709137211","article-title":"Unusual ureteral obstruction by herniation of ureter into sciatic foramen","volume":"28","author":"Lindbom","year":"1947","journal-title":"Acta Radiol (Stockh)"},{"key":"2025121423150996000_18.12.e268459.4","doi-asserted-by":"crossref","first-page":"791","DOI":"10.2214\/ajr.107.4.791","article-title":"Sciatic hernia: report of three cases including two with bilateral ureteral involvement","volume":"107","author":"Franken","year":"1969","journal-title":"Am J Roentgenol Radium Ther Nucl Med"},{"key":"2025121423150996000_18.12.e268459.5","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1016\/j.urology.2013.02.047","article-title":"Acute renal failure caused by bilateral ureteral herniation through the sciatic foramen","volume":"81","author":"Whyburn","year":"2013","journal-title":"Urology"},{"key":"2025121423150996000_18.12.e268459.6","article-title":"Uretero-Sciatic Hernia (Lindbom Hernia): A Case Report and Long-Term Follow-Up","volume":"14","author":"Mustafa","year":"2022","journal-title":"Cureus"},{"key":"2025121423150996000_18.12.e268459.7","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2018-225523","article-title":"Obstructive urosepsis secondary to ureteric herniation into the sciatic foramen","volume":"2018","author":"Fadel","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025121423150996000_18.12.e268459.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2021.106333","article-title":"Bilateral sciatic hernias in an elderly woman successfully managed with robotic surgery: A case report and literature review","volume":"86","author":"Zeng","year":"2021","journal-title":"Int J Surg Case Rep"},{"key":"2025121423150996000_18.12.e268459.9","article-title":"A Rare Case of Inguinal Hernia of a Ureter Belonging to a Duplex Kidney","volume":"2023","author":"Dashtkoohi","year":"2023","journal-title":"Case Rep Surg"},{"key":"2025121423150996000_18.12.e268459.10","doi-asserted-by":"crossref","first-page":"221","DOI":"10.4103\/iju.IJU_138_20","article-title":"Spontaneous bilateral extraperitoneal ureteroinguinal herniation","volume":"36","author":"Gupta","year":"2020","journal-title":"Indian J Urol"},{"key":"2025121423150996000_18.12.e268459.11","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2010.65"},{"key":"2025121423150996000_18.12.e268459.12","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2214\/ajr.175.1.1750181","article-title":"Percutaneous reduction of ureterosciatic hernia","volume":"175","author":"Weintraub","year":"2000","journal-title":"AJR Am J Roentgenol"},{"key":"2025121423150996000_18.12.e268459.13","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1007\/s00192-023-05519-z","article-title":"A serious consequence of pelvic organ prolapse: Hydroureteronephrosis","volume":"34","author":"Serin","year":"2023","journal-title":"Int Urogynecol J"},{"key":"2025121423150996000_18.12.e268459.14","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-023-01057-6"},{"key":"2025121423150996000_18.12.e268459.15","unstructured":"Surmachevska N , Tiwari V . Corticosteroid induced myopathy. In: StatPearls. StatPearls Publishing, 2025. Available: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557731\/"},{"key":"2025121423150996000_18.12.e268459.16","first-page":"1","article-title":"Laparoscopic Repair of a Ureteric Sciatic Hernia: Report of a Case","volume":"2014","author":"Tsuzaka","year":"2014","journal-title":"Case Rep Urol"},{"key":"2025121423150996000_18.12.e268459.17","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1111\/j.1442-2042.2011.02831.x","article-title":"Ureterosciatic hernia successfully treated by ureteral stent placement","volume":"18","author":"Sugimoto","year":"2011","journal-title":"Int J of Urology"},{"key":"2025121423150996000_18.12.e268459.18","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2017-222908","article-title":"Ureterosciatic hernia treated with ureteral stent placement","volume":"2018","author":"Nakazawa","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025121423150996000_18.12.e268459.19","article-title":"Obstructive urosepsis caused by ureterosciatic hernia: A case report","volume":"47","author":"Yanagida","year":"2023","journal-title":"Urol Case Rep"},{"key":"2025121423150996000_18.12.e268459.20","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1053\/j.tvir.2016.06.002","article-title":"Urinary Drainage Procedures in Interventional Radiology","volume":"19","author":"Thornton","year":"2016","journal-title":"Tech Vasc Interv Radiol"},{"key":"2025121423150996000_18.12.e268459.21","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.jvir.2020.07.029","article-title":"Society of Interventional Radiology Quality Improvement Standards for Percutaneous Nephrostomy in the Pediatric Population","volume":"32","author":"Cahill","year":"2021","journal-title":"J Vasc Interv Radiol"},{"key":"2025121423150996000_18.12.e268459.22","doi-asserted-by":"crossref","first-page":"769","DOI":"10.25122\/jml-2021-0352","article-title":"Ureteral stent complications \u2013 experience on 50,000 procedures","volume":"14","author":"Geavlete","year":"2021","journal-title":"JMedLife"},{"key":"2025121423150996000_18.12.e268459.23","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1016\/j.urology.2016.08.014","article-title":"Ruptured Renal Pelvis Due to Obstruction by Ureterosciatic Hernia: A Rare Condition With a Rare Complication","volume":"97","author":"Wai","year":"2016","journal-title":"Urology"},{"key":"2025121423150996000_18.12.e268459.24","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/S0090-4295(99)00199-5","article-title":"Laparoscopic repair of ureterosciatic hernia","volume":"54","author":"Gee","year":"1999","journal-title":"Urology"},{"key":"2025121423150996000_18.12.e268459.25","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2022.e10488","article-title":"One case report of laparoscopic biological patch repair for the ureterosciatic hernia and literature review","volume":"8","author":"Li","year":"2022","journal-title":"Heliyon"},{"key":"2025121423150996000_18.12.e268459.26","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.urols.2013.05.006","article-title":"Laparoscopic surgery to treat ureterosciatic herniation after ureteral stent failure","volume":"25","author":"Tai","year":"2014","journal-title":"Urol Sci"},{"key":"2025121423150996000_18.12.e268459.27","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.urology.2020.03.017","article-title":"Laparoscopic Repair of Ureteral Diverticulum Caused by Ureterosciatic Hernia","volume":"140","author":"Kubota","year":"2020","journal-title":"Urology"},{"key":"2025121423150996000_18.12.e268459.28","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1308\/147870807X227836","article-title":"An unusual case of a ureteric hernia into the sciatic foramen causing urinary sepsis: successfully treated laparoscopically","volume":"89","author":"Witney-Smith","year":"2007","journal-title":"Ann R Coll Surg Engl"},{"key":"2025121423150996000_18.12.e268459.29","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1177\/000313480907501123","article-title":"An Unusual Presentation of a Sciatic Hernia","volume":"75","author":"Speeg","year":"2009","journal-title":"Am Surg"},{"key":"2025121423150996000_18.12.e268459.30","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.jviscsurg.2018.12.002","article-title":"Management of Lindbom\u2019s hernia (ureterosciatic hernia)","volume":"156","author":"Destan","year":"2019","journal-title":"J Visc Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268459","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T07:15:24Z","timestamp":1765782924000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268459"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":30,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,14]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bcr-2025-268459"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268459","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}