case_images: PMC11807240_01
case_images: Voiding cystourethrography (VCUG) and renal scintigraphy images. The VCUG disclosed grade 4 right and grade 1 left VUR. However, we should have noticed that the left side seems to be atypical, as grade 1 VUR retrospectively, bilateral ureteroneocystostomy had been scheduled.. A: Voiding phase; B: Post-voiding image of frontal view. 99mTc-dimercaptosuccinic acid (DMSA) static renal scintigraphy showed a right atrophic kidney and scarring. . C: Right posterior oblique (RPO); D: Left posterior oblique (LPO)
case_images: cureus-0017-00000077209-i01.jpg
case_images: PMC11807240_01_cureus-0017-00000077209-i01.jpg
case_images: FIG1
case_images: Voiding cystourethrography (VCUG) disclosed grade 4 right and grade 1 left VUR (Figures 1A, 1B). 99mTc-dimercaptosuccinic acid (DMSA) static renal scintigraphy showed severe renal atrophy and scarring on the right kidney (Figures 1C, 1D). 
case_images: Cystourethroscopy images. Cysturethrscopy was performed since concomitant urethral stricture had been suspected. Bladder trigone atrophy, hypoplasia of the posterior urethra, and no urethral stricture were observed.
case_images: cureus-0017-00000077209-i02.jpg
case_images: PMC11807240_01_cureus-0017-00000077209-i02.jpg
case_images: FIG2
case_images: No urethral stricture was observed, and it revealed bladder trigone atrophy and two side-by-side orifices (Figures 2, 3).
case_images: Retrograde urography images. Two orifices were identified on the left side. The upper side was identified as the left ureteral orifice by retrograde urography. The lower side, diagnosed as a grade 1 vesicoureteral reflux, remained unknown. We speculated that the left ectopic vas deferens opened into the bladder, causing recurrent epididymitis.
case_images: cureus-0017-00000077209-i03.jpg
case_images: PMC11807240_01_cureus-0017-00000077209-i03.jpg
case_images: FIG3
case_images: No urethral stricture was observed, and it revealed bladder trigone atrophy and two side-by-side orifices (Figures 2, 3).
case_images: Intraoperative findings . The left ureter and vas deferens (vas) were identified.
case_images: cureus-0017-00000077209-i04.jpg
case_images: PMC11807240_01_cureus-0017-00000077209-i04.jpg
case_images: FIG4
case_images: One duct was confirmed as the left ureter, and the other was a vas deferens connected to scrotal structures (Figure 4).