Renal aplasia with concomitant ipsilateral megaureter and ureterocele is very uncommon and most of the reported cases in the literature were managed by ureterectomy. So, we aimed to report a case of ipsilateral renal aplasia, megaureter and ureterocele who was managed by ultrasound-guided aspiration.

This case was reported from a tertiary care center. Full clinical and radiological assessment was performed to confirm the diagnosis. Ultrasound-guided aspiration of the megaureter was done. The patient was then followed up by clinical evaluation and renal & bladder ultrasonography (RBUS).

A 7-year-old boy presented with suprapubic pain and recurrent urinary tract infections (UTIs). RBUS and magnetic resonance urography (MRU) showed normal right kidney, non-visualized left kidney with left ureteral dilation and left ureterocele (Figure 1). Voiding cystourethrogram (VCUG) revealed adequate bladder capacity with free urethral flow of urine and no vesicoureteral reflux on both sides. Tc-99m dimercaptosuccinic acid (DMSA) scan showed normal right kidney and no tracer uptake at the site of the left kidney. Ultrasound-guided aspiration of the left megaureter was done and it yielded 50 mL of clear fluid that appeared to be urine. After 3 months, the patient reported complete relief of the suprapubic pain and no further attacks of UTIs. Follow-up RBUS showed complete resolution of the left ureteral dilation and reduction in the size of the left ureterocele (Figure 2).

A case of a young boy who presented with suprapubic pain and recurrent UTIs, was reported. His radiological images showed normal right kidney, non-visualized left kidney with left ureteral dilation and left ureterocele, adequate bladder capacity with free urethral flow of urine and no vesicoureteral reflux on both sides. He was then managed by ultrasound-guided aspiration of the left megaureter that yielded 50 mL of urine. Three months later, the patient reported complete relief of pain and UTIs with complete resolution of the left ureteral dilation and reduction in the size of the left ureterocele.

Ipsilateral renal aplasia, megaureter and ureterocele is a rare entity that could be successfully managed by a minimally-invasive technique, such as ultrasound-guided aspiration rather than open or laparoscopic surgeries.