a marked delay in excretion and hydronephrosis on the Case report left. A voiding cysto-urethrogram failed to detect VUR and a renal scan showed no function in the left kidney. A 37-year-old man presented with a left-sided scrotal swelling, dysuria and fever consistent with the clinical CT of the abdomen showed a hydronephrotic left kidney with a dilated tortuous ureter (Fig. 2) involving the left diagnosis of acute epididymitis. During the last few years he had experienced similar episodes of epididymitis on seminal vesicle and ending ectopically in the prostate. On cystoscopy, the right ureteric orifice was positioned the left, with no further investigation. The patient was married and had fathered four children. Urine analysis normally, but no left orifice could be identified. The epididymitis resolved completely under treatment with showed white blood cells (WBC, 500/mL) and no bacteriuria; urine culture was sterile and cultures for Chlamydia, oral antibiotics. After 4 weeks, a left nephroureterectomy and resection of the left seminal vesicle Ureaplasma, Mycoplasma and tuberculosis were negative. Haematology and biochemical screens were within was performed, revealing a trifid ureter passing the left seminal vesicle and ending blindly in the prostate (Fig. 3). normal limits apart from a WBC count of 17 500/mL. Ultrasonography revealed a normal right kidney but onThe post-operative course was uneventful and the patient has had no recurrence of epididymitis for 12 months. the left there was marked hydronephrosis with no evidence of a renal cortex; a dilated and tortuous ureter could be followed down to the bladder base. TRUS was