Large bladder diverticulum causing direct extrinsic compression of the left ureter

Bladder diverticula are herniations of the bladder mucosa through the muscular layer and can be congenital or acquired. Acquired bladder diverticula are almost always associated with bladder outlet obstruction. Bladder diverticula are uncommon and often asymptomatic, however, can present with non-specific lower urinary tract symptoms, haematuria, or urinary tract infection. We report a rare case of a large bladder diverticulum causing extrinsic left ureteric compression in a 37-year-old male with a high bladder neck presenting as left flank pain and hydronephrosis. A bladder neck incision successfully resolved voiding symptoms and decompressed the diverticulum leading to resolution of ureteric obstruction.