Bladder diverticulum

 

Bladder diverticulum are small, bulging pouches in the bladder. They are very common and increase in frequency with age. Most people who have diverticulum of the bladder will never know it. These pouches are usually harmless but below we discuss what problems they can cause.

 

What is a bladder diverticulum?

 

They are pouches in the bladder wall that a person is born with (congenital) or later acquires. A congenital bladder diverticulum represents an area of weakness in the bladder wall through which some of the lining of the bladder is forced out. (A small balloon squeezed in a fist will create a diverticular-like effect between the fingers.) Bladder diverticula may be multiple and they often occur at the entrance of the upper urinary system into the bladder (ureterovesical junction). Acquired diverticula are usually related to bladder obstruction, most commonly as a result of benign prostatic enlargement causing bladder outflow obstruction.

26/4/2010 | 4Urology Administrator
 

What are the symptoms of bladder diverticulum?

 

Under normal conditions a diverticulum is of no significance. But sometimes it causes special problems if a bladder tumor happens to be in one, or if one is next to a ureter that allows urine to go from the bladder back up to the kidney (vesicoureteral reflux). Under most situations however, diverticula are without symptoms and not clinically significant. A diverticulum usually becomes significant if it becomes very large and causes incomplete bladder emptying and stagnation of urine. If the urine within the diverticulum becomes infected, that infection may not be able to clear because of the stagnation. Under such circumstances, treatment may be indicated. If a diverticulum is related to bladder outlet obstruction, the obstruction must also be treated.

26/4/2010 | 4Urology Administrator
 

How is bladder diverticulum diagnosed?

 

Diverticulum is not visible and will be detected only if it causes trouble. Usually it is found during an examination for the cause of recurring urinary tract infections. X-rays or a cystoscopy is used to identify it.

26/4/2010 | 4Urology Administrator
 

How is bladder diverticulum treated?

 

Surgical removal is the treatment of a symptomatic bladder diverticulum. This may be done from entirely within the bladder in certain situations, but often requires dissection both inside and outside of the bladder. This surgery may be somewhat difficult because of the inflammation of a chronically infected diverticulum.

26/4/2010 | 4Urology Administrator
 

What can be expected after treatment for bladder diverticulum?

 

Treatment will usually have good results. Postoperatively, catheter drainage of the bladder is indicated for one to two weeks. Bladder diverticula are either congenital (you are born with them) or acquired. Acquired diverticula are usually related to bladder obstruction, most commonly as a result of Benign Prostatic Hypertrophy. Those that become symptomatic usually are large singular diverticula.


Under normal conditions a diverticulum is of no significance. They sometimes present special problems if a bladder tumor happens to be in one, or if one is next to a ureter that allows vesicoureteral reflux (urine can go from the bladder back up to the kidney). Under most situations however, they are asymptomatic and not clinically significant. A diverticulum usually becomes significant if it becomes very large and therefore is a cause of incomplete bladder emptying and stagnation of urine. If the urine within the diverticulum becomes infected, that infection may not be able to clear because of the stagnation. Under such circumstances, treatment may be indicated. If a diverticulum is related to bladder outlet obstruction, the obstruction must also be treated.


Treatment of a symptomatic bladder diverticulum is surgical excision. This may be done from entirely within the bladder in certain situations, but often requires dissection both inside and outside of the bladder. This surgery may be somewhat difficult because of the inflammation of a chronically infected diverticulum. Nevertheless treatment will usually have good results. Postoperatively catheter drainage of the bladder is indicated for 1-2 weeks.
 

26/4/2010 | 4Urology Administrator