Giant bladder diverticulum

Abstract

We present the case of a 73-year-old man affected by progressive and painful abdominal distension and paresthesia/hypoesthesia at the left leg. US and CT-scan revealed the presence in the left retroperitoneum of a large cystic mass without parietal thickening or enhancement after contrast injection. This mass disappeared after positioning a vesical Foley's catheter and a retrograde cystography confirmed the suspected diagnosis of a large bladder diverticulum due to a severe prostatic hypertrophy; the patient underwent an open diverticulectomy and endoscopic prostatic resection. Bladder diverticula can occasionally appear as complex pelvic masses not obviously connected to the bladder, eventually leading to diagnostic confusion; while small size diverticulum resolves with relief of bladder outlet obstruction, open or laparoscopic diverticulectomy is needed in large size diverticulum if symptomatic, even considering the possible tumor harboring.

Computed tomographic retrograde positive contrast cystography and computed tomographic excretory urography characterization of a urinary bladder diverticulum in a dog

“…Acquired diverticula are commonly secondary to trauma or outflow obstructions. A bladder diverticulum is considered ‘‘giant’’ when it presents a maximum diameter ≥5 cm . Most congenital bladder diverticula in the dog and the cat have been reported at the vesicular apex associated with urachal abnormalities and none of the previously reported diverticula were as large as the one seen in the currently described case .…”

“…In the current case, CT retrograde positive contrast cystography and CT excretory urography clearly showed the size, location, shape, and opening of a large urinary bladder diverticulum in a young dog with when it presents a maximum diameter ≥5 cm. 2 Most congenital bladder diverticula in the dog and the cat have been reported at the vesicular apex associated with urachal abnormalities and none of the previously reported diverticula were as large as the one seen in the currently described case. [3][4][5][6] In the present case, the diverticulum was located in the caudodorsal aspect of the bladder at the level of the bladder neck and measured ≥5 cm in diameter.…”

“…The management of congenital bladder diverticula depends on presentation. Although small, asymptomatic congenital diverticula can be treated conservatively, surgical excision is indicated in giant or symptomatic diverticula . In the present case, clinical signs at initial presentation disappeared after diverticulectomy and up to date the dog has not shown any clinical signs associated with urinary tract disease.…”

Syncope in a Patient with Giant Bladder Diverticulum

“…Bladder diverticula are asymptomatic and of little significance in most cases, but giant bladder diverticula may cause adverse events, e.g., mechanical bowel obstruction (10), inguinal hernia (11), or leg paresthesia (12). The present case is the first report of giant bladder diverticula as a clue to the diagnosis of neurally mediated syncope.…”

Occasional finding of giant bladder diverticulum that simulated an ovarian cyst: A case report and literature review

“…In fact, a bladder diverticulum can occasionally appear as a complex pelvic mass, not clearly connected to the bladder. This could cause diagnostic confusion . Sometimes, bladder diverticula simulate ovarian cysts, especially if the bladder has not adequately voided before the ultrasonography evaluation.…”