Abstract
Pelvic ectopic kidney with pelviureteric junction obstruction is rare and poses significant reconstructive challenges. We report a 35-year-old man presenting with a giant palpable abdominal mass caused by congenital obstruction in a malrotated pelvic ectopic kidney. Diuretic renography showed 11.6% split renal function. The patient underwent successful transperitoneal laparoscopic Anderson-Hynes pyeloplasty with Butler flap reconstruction and double-J stenting. Recovery was uneventful. Six-month renography demonstrated improved drainage with split renal function increasing to 22%, while the patient remained asymptomatic at one-year follow-up. This case highlights the feasibility of laparoscopic renal-preserving reconstruction even in poorly functioning ectopic kidneys with complex anatomy.