Unusual Triad of Unilateral Renal Agenesis, Ipsilateral Ureterocele, and a Blind-Ending Distal Ureter in an Adult: A Case Report

In adults, a ureterocele is a solitary, intravesical abnormality with the normal ureteral insertion at the vesicoureteral junction. We present the case of a 47-year-old man with symptoms of mixed voiding and storage lower urinary tract symptoms, demonstrating the unusual combination of ureterocele, renal agenesis, and a blind-ending ureter on the ipsilateral side, as well as its clinical manifestation and treatment. The right-sided renal agenesis and ureterocele were incidentally found on imaging during the workup. A magnetic resonance imaging (MRI) scan confirmed that the right kidney was absent, which was not seen by an ultrasound, and also noted a ureterocele. Cystoscopy confirmed the diagnosis of the ureterocele. The blind-ending distal ureter was noted during retrograde pyelography, and an endoscopic incision was successfully performed, after which the patient recovered well. Our case report gives more importance to the existence of these anomalies and the understanding of their embryological basis. The knowledge clinicians possess regarding ureterocele in adults with renal agenesis will help them be suspicious of patients presenting with lower urinary tract symptoms or frequent urinary tract infections. Early imaging and endoscopic treatment are crucial to prevent complications, including contralateral renal damage, and improve outcomes.