A bladder diverticulum is a tiny pouch located in the wall of your bladder. It can be present at birth or occur later in life. A bladder diverticulum that is present at birth is referred to as congenital. Non-congenital diverticulum is known as an acquired bladder diverticulum.
Congenital bladder diverticulum occurs when a small portion of the bladder lining pushes through the bladder wall. It usually only consists of one pouch and rarely needs to be treated.
However, acquired bladder diverticula consists of multiple pouches in the bladder wall. This condition is usually the result of a blockage in the urethra or prostate. Improper bladder function due to a nerve injury can also result in acquired bladder diverticula.
Acquired bladder diverticulum is most common in older men. This is because they are more prone to blockages in the urethra and prostate. Middle-aged adults can also develop acquired bladder diverticula, but it is exceedingly rare.
A bladder diverticulum often has minimal symptoms. Instead, it is usually located while addressing other urinary problems. Bladder diverticula are typically linked to conditions such as:
- Urinary tract infections (UTIs)
- Urinary reflux (urine flowing back into the kidneys)
- Bladder stones
- Difficulty urinating
- Bladder tumors
If you are experiencing any of these conditions, then bladder diverticula may also be present.
Bladder diverticula can be diagnosed with imaging such as X-rays or ultrasounds and a contrast material. This technique is known as a voiding cystourethrogram or VCUG.
During a VCUG, the physician will fill the patient’s bladder with the liquid contrast material. The doctor will take a series of images with the X-ray or ultrasound equipment as the patient’s bladder fills. They will also take images when the patient urinates. A VCUG allows doctors to detect issues with the:
- Urethra: The tube connecting the bladder to the exterior of the body
- Ureters: The tubes connecting the bladder and kidneys
- Bladder: Urine storage sac in the lower abdomen
Bladder diverticula can be caused by blockages in the bladder itself or the ureters. It is essential that physicians check all aspects of the urinary tract so that they can address the cause of your bladder diverticulum.
Fortunately, not every patient requires treatment for bladder diverticulum. If your diverticulum is not actively causing you problems, then treatment can be delayed or avoided altogether.
Some patients are not quite as lucky. A diverticulum is sometimes caused by a blockage in the bladder. In these cases, the condition must be treated via surgical intervention. During the operation, the physician will remove the blockage and diverticulum.
There are two surgical methods available, which are:
Open surgery is the more invasive option, but it becomes necessary if the patient has severe infection and swelling. Open surgery allows physicians to gain optimal access to the affected area and address the root cause of the bladder diverticulum.
Many patients are eligible for robotic-assisted surgery. During this far less-invasive procedure, the physician will make a series of small incisions and insert tubes into the bladder. These tubes contain cameras and tiny surgical tools. The doctor will remove the blockage and diverticulum.
Robotic surgery offers patients faster recovery times and less postoperative discomfort. It is also faster and causes far less bleeding, which further improves patient outcomes.