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Bladder Diverticula

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  3. Bladder Diverticula

Overview of Bladder Diverticula

The bladder diverticulum is a formation of a pouch or sac coming out from the bladder wall. A person may either be born with it or may acquire it later in life. Its epidemiology says that there are two peak levels of disease, one at 10 years and the other is 55 to 70 years of age.
It is a congenital disease in children who do not require any treatment. Among adults, the condition may arise due to a medical condition and disease treatment depends upon the cause.

Signs and Symptoms of Bladder Diverticula

Bladder diverticula do not show any symptoms but can be detected during urinary-related problems. 

  • Urinary retention (impairment during urination)
  • Blood in the urine
  • Lower abdominal fullness
  • Abdominal pain and discomfort
  • Difficulty in passing urine
  • Urinary reflux (flow back towards the kidneys)
  • Pain and fever due to inflammation of a diverticulum

Types of Bladder Diverticula

There are two types of Bladder Diverticulum based on the patient’s condition:

  • Congenital:  An individual born with bladder dysfunction is known to suffer from congenital bladder diverticulum. A sac or pouch is formed on the affected part of the bladder line and only 1 pouch is present on it. It is usually diagnosed at the time of birth.

  • Acquired:  In this type, an individual suffers from bladder diverticulum when there is a blockage in the bladder outlet (due to the swollen prostate or urethra scars) or the bladder is not functioning properly (due to nerve injury, or before bladder surgery). This condition forms more than 1 diverticulum pouch in the bladder. It is mostly found in older people who are having a problem with bladder outlet blockage.

Causes of Bladder Diverticula

There are several causes of bladder diverticulum that usually affect people above 50 years. Some of them are given below:

Hutch Diverticula: It is commonly present in males. This is a birth defect in bladder muscles in which outward bulges come out from the ureter opening into the bladder.

Bladder Neck Obstruction: It is observed in males above 50 years of age. This causes the compression of the bladder neck and affects bladder muscles.

Neurogenic Bladder: It is related to nervous system disorders which cause bladder muscle destruction. These nervous system disorders are:

  • Diabetes
  • Parkinson disease
  • Multiple sclerosis
  • Spinal injury
  • Heavy metal poisoning
  • Spina bifida

Posterior Urethral Valves: It is also found in males. It occurs due to the obstruction of posterior urethral valves.

Enlarged Prostate: It gives pressure on the bladder muscles that loosen its strength.

Urethral Stricture: It refers to the narrowing down of the urethral passage that occurs either due to infection or inflammation.

Menkes Syndrome: Menkes syndrome is basically the weakening of bladder muscles that forms a bulge outwards forcefully as it is filled with urine. It mainly occurs due to low copper levels in the body.

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Risk Factors of Bladder Diverticula

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Prevention

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Diagnosis

Bladder diverticula is often diagnosed through imaging tests such as CT scans (computerized tomography) or ultrasounds. Sometimes, when a urologist needs to identify the incidental findings that may suspect the bladder diverticulum. Then, a urologist may recommend a more specific test that involves:

  • Cystoscopy (placing a scope into the bladder via the urethra): This test is a non-invasive procedure. It is performed to examine the inside view of the urinary tract. This will assist the doctor to determine any abnormalities in the bladder, ureter, and urethra. It is tolerable for most people and has minor risks. Generally, It will take 10-15 minutes.

  •  Bladder X-ray: In this test, the bladder is filled with dye to see the contrast picture of the diverticula properly.

  •  Urodynamic Test: It measures the pressure and volume of the urine in the bladder and can also assess the urethra functionality and whether it is working properly or not.

Treatment of Bladder Diverticula | When to Consult a Doctor

If an individual is not experiencing chronic complications (urinary infections, bladder stones, or urinary reflux) associated with congenital or acquired bladder diverticulum, then they do not need any kind of treatment. But if there is an association of bladder tumors, recurrent infection, or urinary retention along with bladder diverticulum, then a doctor will recommend surgical treatment. For example, if a patient with diverticula and urinary obstruction, can be treated by both open and closed laparoscopic surgery for the permanent relief of obstruction.
In some cases, the bladder’s diverticula are removed during the cystoscopy procedure. For a person who cannot undergo open surgery the diverticula opening is enlarged into the bladder cavity. This is another method of treatment.

In case you exhibit any concerning signs and symptoms of bladder diverticulum, consult a medical professional as soon as possible.

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