Concomitant occurrence of pyelocalyceal diverticulum and ipsilateral large sized orthotopic ureterocele in an adult: a rare association

Pyelocalyceal diverticulum is an incidental finding detected on routine ultrasonography scans which may also show symptoms of recurrent urinary tract infections secondary to urinary stasis and calculi formation within the diverticulum. Orthotopic type of ureterocele occurs as an isolated abnormality and is mostly confined to adults as opposed to ectopic type of ureterocele which is congenital in origin and commonly seen in children and is almost always associated with a duplicated collecting system. We report a case of concomitant occurrence of pyelocalyceal diverticulum and ipsilateral large sized orthotopic ureterocele diagnosed on high-resolution ultrasonography and confirmed on contrast enhanced computed tomography in a 54-year-old adult female. The patient underwent resection of the ureterocele with insertion of left sided double-J ureteral stent which was left in place for 4 weeks following which the patient's symptoms improved and she was discharged after an uneventful post-operative recovery period.