Ureteral cysts are not always treated surgically. Ureteral cysts refer to a cystic dilatation of the end of the ureter where it joins the bladder and protrudes into the bladder. The cause of ureteral cyst formation is not well understood and the clinical presentation varies. When the ureteral opening is narrowed or when secondary infection occurs, it can manifest as bladder irritation symptoms such as urinary frequency, urinary urgency and pain, as well as hematuria, back pain and difficulty in urination. For smaller simple cysts, if there is no obstruction or reflux, they can be left untreated and observed regularly. For larger ureteral cysts, which can cause obstruction, recurrent infection or cause hydronephrosis or stones, surgery is often required. Surgery can be done to remove cysts, mostly by transurethral cyst electrosurgery, which is a minimally invasive procedure.