Inverted Y duplication of the ureter in association with ureterocele and bladder diverticulum

We report a case of inverted Y duplication of the ureter in association with an obstructing ectopic ureterocele and paraureteral diverticulum. Preoperative radiological studies demonstrated the ureterocele and diverticulum but they failed to show the duplex distal ureter. The duplicated section of ureter was excised and a Cohen reimplantation was performed. The presence of a large ureterocele obstructing the bladder neck, a diverticulum, failure of reflux into the ectopic segment and poor function of the affected kidney all contributed to the difficulties in establishing a preoperative diagnosis.