Ureteroceles are congenital cystic dilatations of the distal ureter, usually diagnosed in childhood. Symptomatic cases in adults are rare, and giant intravesical ureteroceles with intermittent urethral prolapse are exceptionally uncommon. Optimal management in adults is debated, particularly in balancing symptom relief against the risk of postoperative vesicoureteral reflux.

A 48-year-old woman presented with a giant (6.8 cm) right-sided orthotopic intravesical ureterocele causing intermittent urethral prolapse and obstructive lower urinary tract symptoms. Because renal function was preserved and complaints were limited, conservative management was initially chosen. Progression to significant functional impairment led to endoscopic transurethral resection (deroofing). Recovery was uncomplicated, with complete symptom resolution and no hydronephrosis or signs suggestive of reflux on follow-up imaging.

Endoscopic treatment of a giant prolapsed intravesical ureterocele in adults can be safe and effective after careful selection and requires long-term follow-up to monitor for reflux.

Keywords : ureterocele, prolapse, endoscopic treatment