Treatment of Bladder Diverticula, Impaired Detrusor Contractility, and Low Bladder Compliance

Powell, Charles R.; Kreder, Karl J.

doi:10.1016/j.ucl.2009.08.002

Cited by 19 publications

(11 citation statements)

References 52 publications

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“…Although no treatment for urinary bladder diverticulitis has been described, there are several approaches to treat bladder diverticuli [8]. Correction of bladder outlet obstruction is the first line of therapy in patients with diverticuli formed secondary to obstruction, including those with prostatic disease and children with urethral valves [9, 10].…”

Section: Discussionmentioning

confidence: 99%

Bladder Diverticulitis: A Case Report

Silberman

Jeanmonod

2011

Case Reports in Emergency Medicine

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Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.

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Section: Discussionmentioning

confidence: 99%

Bladder Diverticulitis: A Case Report

Silberman

Jeanmonod

2011

Case Reports in Emergency Medicine

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“…The classic indications for surgery of BD includes presence of tumor, persistent urinary tract infections, bladder stone, hydronephrosis caused by the diverticula, urinary retention with poorly draining diverticula and severe LUTS with paradoxal incontinence ( 1 , 2 , 14 ). A large size with small drainage orifice and diverticula in young man also can be strong indications for surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The urine stasis in the diverticula can lead to complications such as stone formation, urinary tract infection (UTI) and tumors. The incidence of tumors in the diverticula range from 2 to 10% and due to the lack of the smooth muscle layer, the prognosis is usually worst ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Publications about acquired BD are scarce in the contemporary urology literature and some authors consider it as consequence of advances in the treatment of BPH ( 2 ). In the other hand, the widespread use of medical treatment for BPH in the last 20 years may have caused an elevated incidence of BD due to an increase of bladder damage secondary to longer periods of obstruction.…”

Section: Introductionmentioning

confidence: 99%

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The role of bladder diverticula in the prevalence of acute urinary retention in patients with BPH who are candidates to surgery

et al. 2018

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Introduction:The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood.Objectives:To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery.Subjects and Methods:We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis.Results:There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012).Conclusions:The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.

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“…Note the close proximity of the right ureter to the diverticulum. (Reprinted from Urol Clin North Am, volume 36/edition 4, Treatment of bladder diverticula, impaired detrusor contractility, and low bladder compliance, pages 511-525, Copyright 2009, with permission from Elsevier) [37] compliance. Bladder diverticula may cause ureteral deviation with or without compression of the ipsilateral ureter.…”

Section: Imagingmentioning

confidence: 99%

Management of Bladder Diverticula

Blaivas

Chughtai

Tsui

et al. 2011

Curr Bladder Dysfunct Rep

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Bladder diverticula can be congenital or acquired. In adults, they are typically associated with bladder outlet obstruction but may also have iatrogenic causes; they are occasionally associated with bladder cancer. Although they are common in men with bladder obstruction, most diverticula are small and require no treatment other than that required for the outlet obstruction. Indications for surgery include recurrent urinary tract infections, stones, tumors, ureteral obstruction, and symptomatic incomplete bladder emptying. The type of surgery depends on a clear understanding of the degree to which the bladder diverticulum contributes to the patient's condition based on cystoscopy, urodynamics, and upper tract imaging. Because of the increased incidence of bladder cancer, routine surveillance with cystoscopy and cytology has been recommended by some experts, but there are no clear guidelines regarding this. Surgical techniques in the management of bladder diverticula are evolving, especially with laparoscopy and robotics.

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Treatment of Bladder Diverticula, Impaired Detrusor Contractility, and Low Bladder Compliance

Cited by 19 publications

References 52 publications

Bladder Diverticulitis: A Case Report

Bladder Diverticulitis: A Case Report

The role of bladder diverticula in the prevalence of acute urinary retention in patients with BPH who are candidates to surgery

Management of Bladder Diverticula

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