A 44-year-old man presented with gross painful hematuria and frequency. He did not have lithuria, hematospermia or previous urinary tract instrumentation. He had received antitubercular therapy 20 years back for pulmonary tuberculosis and again 1 year before presentation to us. His urine examination and serum biochemistry were normal. Intravenous urogram showed multiple radio-opaque densities in right hemipelvis, normal left kidney and nonvisualized right kidney [Figure 1]. Micturating cystourethrogram revealed calcific densities in right pelvis and grade 1 right vesicoureteral reflux. A diagnosis of right renal agenesis with seminal vesical calculi was made and confirmed with magnetic resonance imaging (MRI) of the pelvis [Figure 2].
He was planned for endoscopic removal of seminal vesical calculi. On cystoscopy, a small stone was seen at the right vesicoureteral junction. Retrograde ureterography revealed that the right ureter was blind ending and dye was seen filling a diverticulum at the lower end of ureter [Figures 2c, and d]. Endoscopic incision of the diverticulum orifice was made. It was full with multiple, tiny, smooth-surfaced calculi which were removed endoscopically.