Surgical treatment of bladder diverticula

Surgical treatment of bladder diverticula

Congenital bladder diverticula should only be treated if symptomatic, or if there is concern regarding malignant transformation. Bladder outlet obstruction should be excluded by flow rate or urodynamic studies prior to any surgical inter - vention, and this should be treated prior to consideration of bladder diverticulectomy . Even large diverticula do not require there is no evidence of bladder outlet obstruction treatment if and the patient is asymptomatic with none of the above complicating factors. Surgical excision of a bladder diverticulum can be per formed through an open approach (Pfannenstiel or low midline abdominal incision) or through minimally invasive (laparoscopic or robotic) techniques. Depending on the prox imity of the neck of the diverticulum to the ureteric orifice patients should be counselled about the possible need for con epair can be performed comitant ureteric reimplantation. R purely extravesically , or through a combined extravesical and h ( Figure 83.8 ). intravesical approac Summary box 83.1 Bladder diverticula /uni25CF /uni25CF /uni25CF

Figure 83.7 Bladder diverticulum seen cystoscopically. Can be congenital or acquired Complications include infection, stones, renal obstruction and rarely malignancy Bladder outlet obstruction should be identi /f_i ed and, if present, treated prior to bladder diverticulectomy