A bladder diverticulum is defined as the herniation of mucosal tissue through the bladder wall, hence creating an outpouching of the wall. Bladder diverticula are either congenital (primary) or acquired (secondary) [1] and the size and number are variable. The former type includes primary congenital bladder diverticulum (PCBD) and congenital syndromes such as Ehlers-Danlos syndrome, Prune-belly syndrome, Diamond-Blackfan syndrome, and others as well. The bladder outpouching in PCBD is not related to obstruction but is a consequence of an inadequate bladder wall due to a deficiency in the detrusor layer [2]. Investigators in one study managing predominantly male children with PCBD revealed that common manifestations included urinary tract infection with fever and hydronephrosis [3].

The acquired form is more common and develops in response to high pressure on the trabeculated bladder wall, which is typically secondary to bladder outlet obstruction in the setting of benign prostatic hypertrophy (BPH) [4]. Although BPH accounts for most cases of bladder diverticula [4], other causes include urethral stricture, bladder neck stenosis, neurogenic bladder, posterior urethral valves, and ureterocele. Diverticula may also result as a postoperative complication.

Regarding the clinical presentation, a majority of diverticula do not produce symptoms and are found incidentally through evaluation for hematuria, urinary tract infection, or bladder outlet obstruction [1]. Men with obstruction secondary to BPH will report trouble with urination and incomplete voiding [4].

Complications

Due longstanding urinary stasis, patients with bladder diverticula are at risk for developing bladder stones and infection [1]. Other serious complications include bladder rupture [5] and intra-diverticular transitional cell carcinoma [6].

• Recurrent Urinary Tract Infection

  Since then he had been suffering from recurrent urinary tract infections and urinary leak, which used to be treated symptomatically. [ncbi.nlm.nih.gov]

• Inguinal Mass

  mass. ( 28325718 ) Nabavizadeh R....Nabavizadeh A. 2017 9 Iatrogenic Bladder Diverticulum 11 Years After Sacrospinous Ligament Fixation for Apical Prolapse. ( 27782977 ) Gephart L.F....Larsen W. 2017 10 Vesico-umbilical fistula in a child with severe [malacards.org]

• Pelvic Mass

  Cystoendoscopic examination and standard radiological techniques occasionally fail to correctly establish that a pelvic mass is due to carcinoma arising within a urinary bladder diverticulum. [ncbi.nlm.nih.gov]

  It is most often manifested by acute retention of urine, recurrent urinary tract infections, or a pelvic mass. Sometimes, the diagnosis is made incidentally. [afrjpaedsurg.org]

• Hypertensive Retinopathy

  This report describes a 15-year-old male adolescent who developed sudden visual disturbance resulting from hypertensive retinopathy. The cause of hypertension was bilateral obstructive uropathy caused by enlarged paraureteral bladder diverticula. [ncbi.nlm.nih.gov]

  Retinopathy. ( 29441752 ) Kim S....Han H.S. 2018 5 Labial swelling; anterior perineal herniation of urinary bladder diverticulum. ( 29604286 ) Khan I....Shah O.A. 2018 6 Congenital Bladder Diverticulum in Adults: A Case Report and Review of the Literature [malacards.org]

• Paresthesia

  We present the case of a 73-year-old man affected by progressive and painful abdominal distension and paresthesia/hypoesthesia at the left leg. [ncbi.nlm.nih.gov]

• Hematuria

  A 47-year-old man presented with hematuria and dysuria. He was found to have a carcinosarcoma originating from a bladder diverticulum. He underwent a partial cystectomy and received postoperative chemotherapy. [ncbi.nlm.nih.gov]

  Regarding the clinical presentation, a majority of diverticula do not produce symptoms and are found incidentally through evaluation for hematuria, urinary tract infection, or bladder outlet obstruction. [symptoma.com]

• Urinary Incontinence

  Eight children with diverticulum of the bladder were among 487 children investigated for persistent urinary incontinence. The incidence, pathology, symptoms, signs, diagnosis and treatment of diverticula of the bladder are discussed. [pediatrics.aappublications.org]

  Tension-free vaginal tape for the treatment of stress urinary incontinence. Clin Obstet Gynecol 2000; 43: 670-675. 24） Mansoor A, Védrine N, Darcq C. [minds.jcqhc.or.jp]

  It may cause VUR, recurrent urinary tract infection, stone formation and urinary incontinence. [indianjurol.com]

  Urinary Incontinence: Urinary incontinence (the involuntary loss of urine) is rare after this surgery. If present before the operation, it is usually due to a pre-existing condition other than the diverticulum. [deltamedix.com]

  Particular attention is paid to the treatment of patients with tumors of the urinary tract, kidneys, urolithiasis, prostate diseases, treatment of urinary incontinence/neurourology, andrology and pediatric urology. [bookinghealth.com]

• Nocturia

  Urethral diverticulum may cause a myriad of symptoms, such as: dysuria nocturia flank pain hematuria pelvic pain dyspareunia incontinence urinary retention recurrent cystitis frequent, urgent urination frequent urinary tract infections Many diverticulum [healthblurbs.com]

  Medlars ProCite RefWorks Reference Manager © 2019 Oxford University Press Close Navbar Search Filter Mobile Microsite Search Term Close search filter search input A previously healthy 73-year-old man visited our clinic for 2 weeks history of dysuria and nocturia [qjmed.oxfordjournals.org]

  His symptoms of difficulty of urination, increased urinary frequency, nocturia and urgency became worse when the groin swelling increased in size. The patient used to reduce the swelling manually to improve the symptoms. [wjes.biomedcentral.com]

While many bladder diverticula are typically discovered incidentally during a workup for urinary features [7], symptomatic cases associated with congenital syndromes, BPH, or other causes should raise the clinician's suspicion for this bladder defect. The diagnosis is confirmed through imaging studies as well as the patient's history and physical exam.

Imaging

Very importantly, investigations such as the voiding cystourethrography (VCUG), ultrasonography (abdominal and bladder), and a nuclear renal scan will collectively guide the urologic team with preoperative and postoperative assessment [8]. Specifically, VCUG is the superior imaging technique for the diagnosis of bladder diverticula [9]. This test produces optimal results when lateral and obliques views are obtained and fluoroscopy is used throughout the procedure [10].

Bladder ultrasonography with color doppler enhancement is another beneficial modality since it helps detect the defect, differentiates it from other lesions, and identifies dilated distal ureters [11]. Furthermore, an intravenous pyelography (IVP) is particularly useful in diagnosing lateral bladder diverticula. Finally, the upper urinary tract should be imaged since bladder diverticula can lead to hydroureteronephrosis [7].

• Creatinine Decreased

  Vesicostomy was done; serum creatinine decreased to 0.45mg%. At 6 months of age, intravesical diverticulectomy with left ureteric tapering and reimplantation was done by Politano Leadbetter technique. [indianjurol.com]

Two years after initial treatment, the patient was well without evidence of tumor relapse. [ncbi.nlm.nih.gov]

➤Treatment of urinary bladder diverticulum with surgical excision of diverticulum ★ Direct prices from the best hospitals in the world $ We will help you save money on treatment ✔ Patient support 24/7 Treatment prices are regulated by national law of [bookinghealth.com]

Small cell carcinoma of the urinary bladder is a mass with swiftly aggressive and metastatic, and with a poor prognosis. [ncbi.nlm.nih.gov]

This case demonstrates that spontaneous bladder rupture may be a rare cause of abdominal complaints and sepsis when the etiology at first seems unclear. [ncbi.nlm.nih.gov]

In spite of differences in views on UBD etiology, it should be said that up to now division of diverticula into true and false ones is the most common classification. [radiologykey.com]

The classification of urinary bladder diverticula according with their etiology and localization is offered, as well as diagnosis and treatment tactics for each forms apart.Surgical treatment in bladder’s diverticula depends on their sizes, associated [ibn.idsi.md]

Pathogenesis Etiology Urachus allows communication between urinary bladder and allantoic sac in fetus. At birth urachus is non-functional and all urine flows through urethra in normal animals. [vetstream.com]

Are examined the epidemiological data (age, gender), the given clinics (functional and physical signs), means of diagnosis and therapeutic results. In this study, only large diverticulums were considered. [afrjpaedsurg.org]

Pytel and Pytel [ 6 ]) False or acquired UBD develop in patients who have had a long-term disturbance of urine discharge from the bladder which appears as urinary difficulty that is most often observed in patients with benign prostate hyperplasia. 3.1 Epidemiology [radiologykey.com]

Epidemiology and risk factors of urothelial bladder cancer. Eur. Urol. 63, 234–241 (2013). 18. Das, S. S. & Amar, A. D. A. Vesical diverticulum associated with bladder carcinoma: therapeutic implications. J. Urol. 136, 1013–1014 (1986). 19. [nature.com]

Pathophysiology Vestigial outpouching of bladder wall at urachal attachment. Diverticulum → failure to void all urine from bladder → development of UTI → scarring of bladder wall → increased risk of UTI. [vetstream.com]

Anatomy, Physiology, and Pathophysiology Bladder diverticulae represent a herniation of the bladder urothelium through the muscularis propria of the bladder wall. [laparoscopy.blogs.com]

It prevents bladder from emptying completely and leads to infection. Treatment - Removing obstruction or surgical removal of the diverticulum. [medindia.net]

Prevention Birth defects often have no precisely identified cause; therefore, prevention is limited to general measures such as early and continuous prenatal care, appropriate nutrition, and a healthy lifestyle. [encyclopedia.com]

This periureteral diverticulum causes vesico-ureteral reflux because it prevents the normal valve mechanism of the distal ureter. [meddean.luc.edu]

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