Surgical Treatment of Bladder Diverticula: Laparoscopic Approach

Faramarzi-Roques, Rozbeh; Calvet, Clélea de Oliveira; Gateau, T.; Ballanger, P

doi:10.1089/089277904322836712

Cited by 27 publications

(15 citation statements)

References 8 publications

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“…We report, to our knowledge, the Wrst robotic-assisted transvesical diverticulectomy with concurrent transvesical simple prostatectomy. Previous to this report, even accomplished laparoscopists have recommended an open approach when a very large prostate gland with BOO is associated with a symptomatic bladder diverticulum [2]. However, with robotic-assisted laparoscopy, it is feasible to approach both the diverticula and the prostatic adenoma in a transvesical fashion in a single operative setting as we have demonstrated.…”

Section: Discussionmentioning

confidence: 83%

“…However, with robotic-assisted laparoscopy, it is feasible to approach both the diverticula and the prostatic adenoma in a transvesical fashion in a single operative setting as we have demonstrated. Several centers have reported feasibility of TURP immediately followed by laparoscopic or robot-assisted laparoscopic extravesical or transvesical diverticulectomy [2][3][4][5]. These techniques typically utilize cystoscopic placement of a catheter or balloon in the diverticulum to preferentially inXate the diverticulum while decompressing the bladder, and ureteral stent placement to aVord better visualization of the ipsilateral ureter [4,14].…”

Section: Discussionmentioning

confidence: 99%

“…This approach allows for eYcient and safe excision of the bladder diverticulum while providing transvesical access for prostatic adenoma excision. Skilled laparoscopists have demonstrated the feasibility of extravesical and transvesical diverticulectomy, with transurethral resection of the prostate (TURP) proceeding or immediately prior to the procedure to provide relief of BOO [2][3][4][5]. However, this technique has failed to gain widespread use due to the long operative times and technical demands of the laparoscopic approach.…”

Section: Introductionmentioning

confidence: 99%

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Robot-assisted laparoscopic transvesical diverticulectomy and simple prostatectomy

2008

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Acquired bladder diverticula are often associated with bladder outlet obstruction (BOO). The increased voiding pressures required to overcome the BOO attenuate the detrusor and promote formation of diverticula. These patients may develop urinary tract infections, bladder stones, and incomplete bladder emptying. Effective treatment must address both the bladder diverticula and BOO. Reports of laparoscopic bladder diverticulectomy with concurrent transurethral resection of the prostate have demonstrated the feasibility of this minimally invasive approach. However, due to longer operative times and technical difficulty of the procedure, the gold-standard treatment remains the open surgical approach of bladder diverticulectomy and transvesical prostatectomy. With the advent of robotic-assisted laparoscopic surgery, application of open surgical principles is increasingly translated to the minimally invasive laparoscopic approach. We report, to our knowledge, the first case of robot-assisted laparoscopic transvesical diverticulectomy and concurrent transvesical simple prostatectomy.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robot-assisted laparoscopic transvesical diverticulectomy and simple prostatectomy

2008

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“…While there have been several reports of laparoscopic bladder diverticulectomy in adults [13][14][15][16][17][18], we have located only one previous report on pediatric laparoscopic extravesical bladder diverticulectomy in the literature that also described concurrent nephroureterectomy in a 6-year-old child [19]. In this approach, identification of the diverticulum from outside of the bladder can be difficult [15].…”

Section: Extravesical Laparoscopic Surgerymentioning

confidence: 95%

Management of Bladder Diverticula in the Pediatric Population

Baek

Sılay

Koh

2016

Curr Bladder Dysfunct Rep

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Bladder diverticula represent protrusion of the urothelial mucosa through the bladder muscular layers and may be either congenital or acquired. Congenital bladder diverticula are usually located adjacent to the ureteral orifices and often are associated with vesicoureteral reflux. Acquired bladder diverticula are usually multiple in nature and are secondary to bladder outlet obstruction or neurogenic bladder. When bladder diverticula are small and do not cause symptoms, non-surgical observation is an acceptable management strategy. The absolute need for surgical intervention of bladder diverticula remains a controversial topic, where current surgical indications for bladder diverticula include diverticula larger than 3 cm, recurrent urinary tract infections, associated severe vesicoureteral reflux, voiding dysfunction, urinary retention, bladder stones, and lower urinary tract symptoms that are persistent after conservative treatment. Open surgical repair has traditionally been the primary treatment choice for bladder diverticula. However, recent advancements in laparoscopic and robotic technology have led to minimally invasive surgical treatment options as alternatives to open surgery with similar success rates, but with reduced morbidity, decreased hospital stay lengths, reduced pain medication requirements, and improved cosmesis.

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“…Faramarzi-Roques et al [24] described a laparoscopic technique in which the diverticulum was dissected down to its neck in five patients. After resection, the neck was closed in two layers.…”

Section: Laparoscopic/robotic Approachmentioning

confidence: 99%

Management of Bladder Diverticula

Blaivas

Chughtai

Tsui

et al. 2011

Curr Bladder Dysfunct Rep

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Bladder diverticula can be congenital or acquired. In adults, they are typically associated with bladder outlet obstruction but may also have iatrogenic causes; they are occasionally associated with bladder cancer. Although they are common in men with bladder obstruction, most diverticula are small and require no treatment other than that required for the outlet obstruction. Indications for surgery include recurrent urinary tract infections, stones, tumors, ureteral obstruction, and symptomatic incomplete bladder emptying. The type of surgery depends on a clear understanding of the degree to which the bladder diverticulum contributes to the patient's condition based on cystoscopy, urodynamics, and upper tract imaging. Because of the increased incidence of bladder cancer, routine surveillance with cystoscopy and cytology has been recommended by some experts, but there are no clear guidelines regarding this. Surgical techniques in the management of bladder diverticula are evolving, especially with laparoscopy and robotics.

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Surgical Treatment of Bladder Diverticula: Laparoscopic Approach

Cited by 27 publications

References 8 publications

Robot-assisted laparoscopic transvesical diverticulectomy and simple prostatectomy

Robot-assisted laparoscopic transvesical diverticulectomy and simple prostatectomy

Management of Bladder Diverticula in the Pediatric Population

Management of Bladder Diverticula

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