Ectopic ureter inserting into the ejaculatory duct: A case report.

A 44-year-old man presented with bilateral flank pain, dysuria, and incomplete bladder emptying. Evaluation demonstrated a non-functioning atrophic left kidney, a markedly dilated tortuous ureter, and an ectopic ureter inserting into the left ejaculatory duct with an associated ejaculatory duct stone. Diagnosis was established using CT, MRI, DMSA scan, cystoscopy, and retrograde pyelography. Surgical findings confirmed the anomaly, and postoperative semen analysis showed hemato- and oligoasthenospermia. This rare congenital urological abnormality illustrates the importance of multimodal imaging and multidisciplinary management to achieve accurate diagnosis and guide appropriate treatment.