Bilateral Simple Orthotopic Ureteroceles in an Adult Male Complaining of Urgency and Pain on Urination

We report a case of a 38-year-old man with a simple orthotopic bilateral ureterocele and pain on urination that was improved by transurethral incision. His symptoms were present for 3 years since he first visited our hospital in 2012. Cystoscopy at our hospital revealed a simple bilateral ureterocele, and he was given an alpha blocker plus anticholinergic agent. The medication did not relieve his symptoms. Three years after his initial visit in 2012, he returned for a re-evaluation in May, 2015, because his symptoms had worsened. Computed Tomography (CT) showed normal locations of the bilateral ureteric orifices in the bladder, bilateral ureterocele with a right-sided predominance and a cobra head sign, and bilateral hydroureter. We performed a transurethral incision of his ureteroceles. Intraoperatively, we found that the ureterocele on the right ureter entered the opening and expanded at the time of urine discharge. The symptoms significantly improved after the procedure.