Figure 4. The retrograde pyelogram shows the typical “curlicue” or “loop-the-loop” sign associated with a ureteroinguinal hernia in a 67-year-old man who presented with urinary symptoms and right inguinal hernia. A ureteral catheter is located in the distal ureter marked by an asterisk. Contrast leaving the catheter initially ascended into the abdomen before making a sharp turn and descending into the patient’s scrotum, where it made a loop and then ascended into the abdomen.