The Treatment of Large Bladder Diverticula

Abstract

Thirty-eight cases of large bladder diverticula treated surgically between 1970 and 1979 were reviewed. Twenty-two underwent diverticulectomy alone and 19 of these had no further trouble during a follow-up period averaging 4.5 years. Three other patients who had undergone resection of a small prostate gland prior to diverticulectomy might also have been cured by diverticulectomy alone. In at least half of the patients presenting with large bladder diverticula no obstructive factor was present and it is concluded that primary diverticula are more common than was previously thought. Clinically, primary diverticula may be distinguished from secondary on the basis of symptoms, cystoscopic findings of trabeculation and urodynamic studies. A more extensive application of the transperitoneal approach in performing diverticulectomy is recommended.

Intraoperative Catheter Management During Laparoscopic Excision of a Giant Bladder Diverticulum

“…An open approach provides the surgeon with a clear view of the area of interest; however, morbidity for the patient is significant in any of the extravesical, 4 intravesical, 5,6 or combination 7 open approaches. Transurethral approaches to excise 3 or fulgurate 1,2 a bladder diverticulum replace open surgery with endoscopy, facilitating concurrent endoscopic resection or incision of the prostate.…”

Management of Bladder Diverticula

“…Complete transection usually mandates ureteral reimplantation into the bladder with or without a psoas hitch. Other complications include urinary tract infection, bleeding, prolonged urinary extravasation postoperatively, urinary fistula, and bowel injury [20,[26][27][28][29].…”

Multiple bladder diverticula treated with robotic approach-assisted with cystoscopy

“…[ 2 ] Acquired BD, also known as secondary, are most commonly diagnosed in the setting of neurogenic vesicourethral dysfunction or bladder outlet obstruction. [ 3 ] Acquired BD use to be multiple, associated with trabeculated bladder and prostatic enlargement in more than 70% of all cases. [ 4 ]…”