[Hidden paths: rare etiology of renal pelvicalyceal dilatation]

This case describes an 80-year-old patient with long-lasting urinary symptoms that did not respond to treatment with alpha-blockers. A detailed examination ultimately revealed a rare combination of a prostate syndrome and an ectopically draining ureter into the prostate, leading to ectasia of the cranial part of the renal pelvicalyceal system on the right side - an unusual diagnosis, especially at this age. This case demonstrates how seemingly benign Lower Urinary Tract Symptoms (LUTS) can sometimes conceal a complex pathology that requires specialized diagnostics. After successful transurethral resection of the prostate (TUR-P), significant improvement of the symptoms was achieved. Additionally, the renal pelvicalyceal system was no longer ectatic.