Bladder Diverticulectomy
What Is Bladder Diverticulectomy?
Bladder diverticulectomy is a surgical procedure performed to remove a bladder diverticulum, which is an abnormal pouch that protrudes through a weakened area of the bladder wall. A diverticulum may be present from birth (congenital) or develop later in life due to increased bladder pressure, commonly caused by bladder outlet obstruction. Although some diverticula do not cause symptoms, larger or complicated diverticula can lead to recurrent urinary tract infections, bladder stones, urinary retention or, rarely, tumours. Bladder diverticulectomy aims to remove the diverticulum, improve bladder emptying and reduce the risk of complications while preserving normal bladder function.
What Are the Benefits of Bladder Diverticulectomy?
Bladder diverticulectomy offers several important benefits for suitable patients. These include:
- Removes the abnormal bladder pouch.
- Improves bladder emptying.
- Reduces the risk of recurrent urinary tract infections.
- Helps prevent bladder stone formation.
- Relieves urinary symptoms such as frequency and incomplete emptying.
- Allows removal of diverticula containing abnormal tissue or tumours.
- Preserves kidney function by improving urinary drainage.
- Enhances overall urinary function and quality of life.
When Is Bladder Diverticulectomy Recommended?
A specialist may recommend bladder diverticulectomy in the following situations:
- Large or symptomatic bladder diverticula.
- Recurrent urinary tract infections.
- Bladder stones developing within a diverticulum.
- Persistent urinary retention or poor bladder emptying.
- Suspected or confirmed tumour within a diverticulum.
- Recurrent blood in the urine.
- Bladder outlet obstruction contributing to diverticulum formation.
- Persistent symptoms despite conservative management.
What Does Preparation for Bladder Diverticulectomy Involve?
Preparation begins with a detailed medical assessment, including a physical examination, blood tests and urine analysis to identify infection or other abnormalities. Imaging studies such as ultrasound, CT scan or cystography help define the size and location of the diverticulum. A cystoscopy is often performed to examine the inside of the bladder and assess the diverticulum directly.
Patients receive instructions regarding fasting before surgery and may need to adjust certain medications, particularly blood-thinning medicines, under medical supervision. If a urinary tract infection is present, antibiotics are prescribed before the procedure. The surgeon discusses the operation, expected benefits, possible risks and recovery process before obtaining informed consent.
How Is Bladder Diverticulectomy Performed?
Bladder diverticulectomy is performed under general anaesthetic using an open, laparoscopic or robotic-assisted approach, depending on the patient's condition and the surgeon's expertise. After accessing the bladder, the surgeon carefully identifies the diverticulum and separates it from the surrounding tissues while protecting nearby structures such as the ureters.
The diverticulum is completely removed, and the opening in the bladder wall is repaired with absorbable sutures to restore the bladder's normal shape and strength. If bladder outlet obstruction, such as an enlarged prostate, has contributed to the diverticulum, it may be treated during the same operation or at a later stage. A urinary catheter is left in place to allow the bladder to heal, and surgical drains may be inserted if necessary. The incisions are then closed, and the patient is transferred to the recovery area for monitoring.
What to Expect during Recovery after Bladder Diverticulectomy?
Most patients remain in hospital for several days following surgery. The urinary catheter usually remains in place for one to two weeks to protect the bladder repair. Mild discomfort, blood-tinged urine and temporary bladder spasms are common during the early recovery period. Patients are encouraged to walk soon after surgery and gradually return to normal activities over four to six weeks. Follow-up appointments and imaging, if required, help confirm that the bladder has healed properly and is emptying effectively.
What Are the Risks and Complications of Bladder Diverticulectomy?
Although bladder diverticulectomy is generally safe, potential risks and complications include:
- Bleeding
- Infection
- Urine leakage from the bladder repair
- Injury to the ureters or nearby organs
- Blood clots
- Temporary difficulty passing urine
- Bladder scarring or reduced capacity
- Recurrent urinary tract infections
- Recurrence of bladder diverticula, although uncommon
- Rare need for additional surgery