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Bladder Diverticulum

Many people may have small, bulging pouches in their bladder and never know it. These pouches are usually harmless but read on to learn more about what problems they can cause.

What is a bladder diverticulum?
Bladder diverticula are pouches in the bladder wall that a person may be either born with (congenital) or later acquire. A congenital bladder diverticulum represents an area of weakness in the bladder wall through which some of the lining of the bladder is allowed to protrude. Congenital diverticula are generally solitary and are most often discovered during childhood. They often require no specific treatment. Acquired bladder diverticula are typically the result of obstruction of the bladder outlet (e.g. an enlarged prostate or area of scarred urethra), bladder dysfunction from nerve injury or, rarely, as a result of prior bladder surgery. Acquired diverticula are often multiple and typically seen in older men (mirroring the incidence of obstruction of the bladder outlet).

What are the symptoms of a bladder diverticulum?
Bladder diverticula often do not produce specific symptoms but may be associated with urinary tract infections, difficulty voiding or abdominal fullness, particularly if they become large causing the bladder to empty incompletely. Most commonly, bladder diverticula have no direct symptoms but are incidentally discovered while looking for causes of other urinary difficulties such as urinary tract infections, trouble urinating or blood in the urine.

How is a bladder diverticulum diagnosed?
Bladder diverticula may be suspected when a patient has symptoms such as recurrent infection, difficulty voiding or abdominal fullness that suggest blockage of the bladder outlet and urinary stasis. However, patients may have no specific symptoms and diverticula can be found while performing tests for other problems. An X-ray test (cystogram) of the bladder performed by filling the bladder with contrast dye and taking pictures is an excellent means of detecting bladder diverticula. Diverticula may also be found by passing a scope into the bladder through the urethra (cystoscopy), which is important for checking that no bladder tumors are found in the diverticulum. The function of the bladder and the presence of obstruction of the bladder outlet may be assessed with a bladder pressure test (urodynamics). Finally, it may be necessary, in some cases, to check the effect of obstruction on the kidneys if obstruction is suspected using ultrasound of the kidneys.

How is a bladder diverticulum treated?
Congenital or acquired diverticula do not always require treatment, particularly if they are not associated with urinary infections, bladder stones, backwards flow of urine into the kidneys (reflux), bladder tumors or difficulty urinating. For those patients with diverticula acquired as a result of bladder obstruction, treatment should include relief of the obstruction and may or may not include removal of the diverticulum. Removal of the diverticulum is via an open surgery with removal from inside the bladder, though surgery outside of the bladder may be necessary as well. This surgery may be somewhat difficult because of the inflammation of a chronically infected diverticulum. In some patients who cannot undergo an open surgery, the diverticulum can be treated by enlarging its opening into the bladder.

What can be expected after treatment for bladder diverticulum?
Treatment will usually have good results and may result in complete resolution of symptoms. In some patients, removal of the underlying cause, such as obstruction of the bladder, may result in no further symptoms and does not require further therapy. In these cases, periodic checks of the diverticulum with a scope in the bladder through the urethra (cystoscopy) may be indicated. Some patients will require removal of the diverticulum via an open surgery either at the time of treatment of the bladder obstruction or subsequently. Occasionally, patients who have poorly functioning bladders will need to assist bladder emptying with a catheter even after treatment. For patients undergoing surgical treatment, catheter drainage of the bladder is indicated for one to two weeks. Rarely, surgical therapy for a bladder diverticulum is associated with injury to the intestines, injury to the urine tubes from the kidneys (ureters), an abnormal connection of the bladder to the intestines (fistula), prolonged urine leakage from the bladder after surgery or infections.



Reviewed January 2011

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Bladder Diverticulum Glossary
  • abdominal: in the abdomen, the cavity of this part of the body containing the stomach, intestines and bladder.

  • bladder: The bladder is a thick muscular balloon-shaped pouch in which urine is stored before being discharged through the urethra.

  • bladder diverticula: 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.

  • catheter: A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray.

  • chronic: Lasting a long time. Chronic diseases develop slowly. Chronic renal (kidney) failure may develop over many years and lead to end-stage renal (kidney) disease.

  • congenital: Present at birth.

  • cyst: An abnormal sac containing gas, fluid or a semisolid material. Cysts may form in kidneys or other parts of the body.

  • cystogram: An X-ray examination of the bladder utilizing contrast material injected into the bladder.

  • cystoscopy: Also known as cystourethroscopy. An examination with a narrow, flexible tube-like instrument passed through the urethra to examine the bladder and urinary tract for structural abnormalities or obstructions, such as tumors or stones.

  • diverticula: Plural of diverticulum. A pouch or sac in the lining of the mucous membrane of an organ.

  • diverticulum: A pouch or sac in the lining of the mucous membrane of an organ.

  • fistula: An abnormal opening between two organs (between the bladder and vagina in women or the bladder and the rectum in men).

  • gene: The basic unit capable of transmitting characteristics from one generation to the next.

  • infection: A condition resulting from the presence of bacteria or other microorganisms.

  • inflammation: Swelling, redness, heat and/or pain produced in the area of the body as a result of irritation, injury or infection.

  • intestine: The part of the digestive system between the stomach and the anus that digests and absorbs food and water.

  • intestines: the portion of the alimentary canal extending from the stomach to the anus consisting of two segments, the small intestine and the large intestine.

  • ions: Electrically charged atoms.

  • kidney: One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.

  • kidneys: One of two bean-shaped organs that filter wastes from the blood and discharge these waste products in urine. The kidneys are located on either side at the level of the 12th ribs toward the back. The kidneys send urine to the bladder through tubes called ureters.

  • obstruction: something that obstructs, blocks, or closes up with an obstacle

  • prostate: A walnut-shaped gland in men that surrounds the urethra at the neck of the bladder. The prostate supplies fluid that goes into semen.

  • reflux: Backward flow.

  • reflux: Backward flow of urine. Also referred to as vesicoureteral reflux (VUR). An abnormal condition in which urine backs up from the bladder into the ureters and occasionally into the kidneys, raising the risk of infection.

  • stone: Small hard mass of mineral material formed in an organ.

  • tumor: An abnormal mass of tissue or growth of cells.

  • ultrasound: Also referred to as a sonogram. A technique that bounces painless sound waves off organs to create an image of their structure to detect abnormalities.

  • ureter: One of two tubes that carry urine from the kidneys to the bladder.

  • ureters: Pair of tubes that carry urine from each kidney to the bladder.

  • ureters: Tubes that carry urine from the kidneys to the bladder.

  • urethra: A tube that carries urine from the bladder to the outside of the body. In males, the urethra serves as the channel through which semen is ejaculated and it extends from the bladder to the tip of the penis. In females, the urethra is much shorter than in males.

  • urge: Strong desire to urinate.

  • urinary: Relating to urine.

  • urinary tract: The system that takes wastes from the blood and carries them out of the body in the form of urine. Passageway from the kidneys to the ureters, bladder and urethra.

  • urinary tract infection: Also referred to as UTI. An illness caused by harmful bacteria, viruses or yeast growing in the urinary tract.

  • urine: Liquid waste product filtered from the blood by the kidneys, stored in the bladder and expelled from the body through the urethra by the act of urinating (voiding). About 96 percent of which is water and the rest waste products.

  • urodynamics: The study of the storage of urine within and the flow of urine through and from the urinary tract.

  • urodynamics: A series of tests that measures the bladder's ability to hold and release urine.

  • void: To urinate, empty the bladder.

  • voiding: Urinating.

Bladder Diverticulum Anatomical Drawings

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