Multiple bladder diverticula treated with robotic approach-assisted with cystoscopy

Preciado-Estrella, D.A.; Cortés-Raygoza, Pascual; Morales-Montor, J.G.; Pacheco-Gahbler, Carlos

doi:10.4103/ua.ua_108_17

Cited by 5 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additionally, BD have been linked to genetic disorders such as Ehlers-Danlos syndrome and Williams-Beuren syndrome. [ 12 ] In our review, we also found evidence suggesting that bladder ultrasound may be more effective than VCUG in diagnosing BD in certain cases, particularly when anterior or posterior diverticula may not be clearly visualized during VCUG due to contrast obscuring the diverticula. [ 13 ] This finding holds potential value for future pre-diagnostic evaluations of such diverticula.…”

Section: Discussionmentioning

confidence: 68%

Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report

Liao,

He,

Wang

et al. 2023

Medicine

View full text Add to dashboard Cite

Introduction: Bladder diverticula (BD) can be classified into congenital and acquired forms, with the latter accounting for approximately 90% of all cases, primarily among male patients. Although BD-associated anatomical bladder outlet obstruction (BOO) is uncommon, existing literature suggests that congenital BD are more frequently observed in male children and rarely in female children. While around 70% of acquired BD are linked to BOO secondary to benign prostatic hyperplasia in male patients, clinical reports of female BD are less common. Furthermore, cases of female BD located posterior to the urethra, which lead to voiding difficulties, are exceedingly rare. Case presentation: Herein, we present a case of laparoscopic treatment in a 53-year-old female patient diagnosed with congenital bladder diverticulum causing progressively worsening dysuria. Voiding cystourethrography revealed a soft cystic protrusion of the posterior urethral wall during voiding, which reinforced the patient’s symptoms. Urodynamic examination showed elevated detrusor muscle contraction during voiding, a reduced urinary flow rate, and P/Q values indicative of significant BOO. Considering the patient’s clinical condition, we performed laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty. Results: The laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty procedures were completed thoroughly and with great success. However, complete removal of the diverticular epithelium proved challenging, resulting in an overall operative time of approximately 3 hours and 32 minutes. At the postoperative follow-up, the patient presented with symptoms of a lower urinary tract infection for a week, which were effectively resolved with oral antibiotics. At the 8-month follow-up, the patient reported normal urination and the absence of any discomfort during urination. Conclusion: Female bladder outlet obstruction resulting from posterior urethral BD can be challenging to visualize during transurethral cystoscopy, especially with limited angulation, and may even be overlooked. Furthermore, conventional transvaginal diverticulectomy is often difficult to perform effectively. Therefore, laparoscopic bladder diverticulectomy, partial urethral croppingplasty, and cystoplasty are considered appropriate treatment options for such cases.

show abstract

Section: Discussionmentioning

confidence: 68%

Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report

Liao,

He,

Wang

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…Actually, the robotic surgery has revolutionized the management of bladder diverticula [19]. The robot-assisted transvesical diverticulectomy is accompanied by some advantages: quick localization of the diverticulum and orifices, direct access to the prostate when simultaneous desobstruction is necessary, and short catheterization time [20,21].…”

Section: Discussionmentioning

confidence: 99%

Multiple Bladder Diverticula Presenting in an 82-Year-Old Congolese Male

Manegabe

Nteranya

Balemba

et al. 2022

Case Reports in Surgery

View full text Add to dashboard Cite

Bladder diverticulum is a congenital malformation characterized by the outpouching of the bladder following an obstruction of urine flux. We present a case of 82-year-old Congolese male patient presented at our facility with a poor urinary stream and lower abdominal pain. A distended abdomen was found on physical examination while the external genitalia were normal. All blood laboratory values were found to be within normal ranges. The patient’s urine analysis revealed an uncountable number of white blood cells. Ultrasonography revealed multiple diverticula in the right posterolateral and posterior wall. An ultrasound of the abdomen revealed numerous bladder diverticula in the bladder’s left posterolateral and posterior aspects, mild right-sided hydronephrosis, and severe left hydronephrosis with a thinned-out cortex. Both ureters were normal. A computed tomographic (CT) scan of the abdomen confirmed the diagnosis. The patient underwent an open laparotomy which allowed complete ablation of the diverticula followed by bladder wall repair. A one-week course of antibiotics was prescribed, and the patient was discharged fully recovered with no immediate complications. Although bladder diverticula are a congenital malformation, the presence of multiple diverticula suggests that the condition is acquired. In elderly patients, open laparotomy combined with intravenous antibiotics yields positive results.

show abstract

“…Large diverticula that cause recurrent urinary tract infections, dysuria, upper urinary tract damage or complications such as stones or tumor require surgical treatment. The first open bladder diverticulectomy in the world was performed by CZERNY (1) in 1897, Traditional open surgery to remove bladder diverticula is very invasive, with many post-operative complications and slow recovery, and is now being replaced by laparoscopic or robotic surgery (2)(3)(4)(5). In 1992 Parra and Boulder (6) reported the first laparoscopic bladder diverticulectomy in the world, and in 2006, Xing et al (7) reported laparoscopic transcatheter bladder diverticulectomy, which has been clinically proven to be feasible, with the advantages of less trauma, less blood loss, less postoperative pain, shorter hospital stay, wider operative field, aesthetic appearance and faster recovery (8).…”

Section: Introductionmentioning

confidence: 99%

One-stage laparoscopy combined with resectoscope in the treatment of huge bladder diverticulum, multiple stones in diverticulum, multiple stones in bladder and benign prostatic hyperplasia: A case report

Zhengqiang

Wang

et al. 2022

Front. Med.

View full text Add to dashboard Cite

BackgroundBladder diverticulum is due to the abnormal arrangement of congenital bladder wall muscle fibers, weak limitations, combined with lower urinary tract obstruction, increased intravesical pressure, and protruding between the self-separated detrusor muscle bundles of the bladder wall. Giant bladder diverticulum refers to 10*8 cm or diverticulum over 150 ml in volume.Case summaryAn 80-year-old male patient was admitted to our hospital on August 14, 2020, the preoperative diagnosis was: bladder diverticulum, bladder diverticulum calculi, multiple bladder stones and prostatic hyperplasia. On August 18, 2020, one-stage laparoscopic bladder diverticulectomy + diverticulum neck incision for stone removal + cystopuncture fistula + transurethral bladder stone removal + transurethral resection of the prostate (TURP) under general anesthesia. First, the bladder diverticulum was separated under laparoscopy, the diverticulum was incised, the diverticulum calculi were taken out, and then the diverticulum was completely removed, and the neck of the diverticulum was extended by 1.5 cm, and the large calculus of about 2.7*3.6 cm was completely removed, and then cystostomy + transurethral Bladder stone removal + TURP. There was no bleeding from the bladder suture during the operation. 200 ml of urine was drained from the extraperitoneal drainage tube, and 20 ml of urine was drained from the abdominal drainage tube during the operation, the urination is smooth, and the general condition can be discharged. The patient’s general condition is good after follow-up.ConclusionOne-stage laparoscopic treatment of bladder diverticulectomy + diverticulum neck incision for stone extraction + cystopuncture fistula + transurethral bladder stone extraction + TURP surgery. There is no report at home and abroad, which can provide diagnosis and treatment ideas and surgical methods for urological colleagues to deal with such diseases.

show abstract

Multiple bladder diverticula treated with robotic approach-assisted with cystoscopy

Cited by 5 publications

References 5 publications

Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report

Laparoscopic surgery for female posterior urethral bladder diverticulum with bladder outlet obstruction: A case report

Multiple Bladder Diverticula Presenting in an 82-Year-Old Congolese Male

One-stage laparoscopy combined with resectoscope in the treatment of huge bladder diverticulum, multiple stones in diverticulum, multiple stones in bladder and benign prostatic hyperplasia: A case report

Contact Info

Product

Resources

About