Summary about Disease
A bladder diverticulum is a pouch-like sac that protrudes from the wall of the urinary bladder. It can be congenital (present at birth) or acquired. Many diverticula are asymptomatic and discovered incidentally. However, large diverticula can cause urinary problems and may require treatment.
Symptoms
Symptoms are not always present, especially with small diverticula. When symptoms occur, they can include:
Frequent urinary tract infections (UTIs)
Difficulty urinating (straining, weak stream)
Feeling of incomplete bladder emptying
Urinary retention
Abdominal pain or discomfort
Blood in the urine (hematuria)
Painful urination (dysuria)
Recurrent kidney stones
Causes
Congenital diverticula: These are present at birth and are due to a weakness in the bladder wall. They are thought to be caused by problems in the formation of the bladder during fetal development.
Acquired diverticula: These develop later in life, usually due to chronic obstruction of the bladder outlet, such as:
Benign prostatic hyperplasia (BPH) in men
Urethral strictures (narrowing of the urethra)
Bladder stones
Neurogenic bladder (bladder dysfunction due to nerve damage)
Medicine Used
Medications may be used to manage symptoms or underlying conditions:
Antibiotics: To treat urinary tract infections.
Alpha-blockers: To relax the muscles in the prostate and bladder neck, improving urine flow in men with BPH.
5-alpha reductase inhibitors: To shrink the prostate in men with BPH.
Anticholinergics: To reduce bladder spasms and urinary frequency/urgency, but these should be used cautiously as they can worsen urinary retention.
Pain relievers: Over-the-counter pain medications may be used for discomfort.
Surgical intervention: Sometimes necessary.
Is Communicable
No, a bladder diverticulum is not communicable. It cannot be spread from person to person.
Precautions
Precautions focus on preventing UTIs and managing underlying conditions:
Stay well-hydrated by drinking plenty of fluids.
Practice good hygiene, including wiping front to back after using the toilet.
Empty the bladder completely when urinating.
Manage underlying conditions such as BPH or neurogenic bladder as directed by a doctor.
Follow all medication instructions.
Avoid holding urine for long periods.
How long does an outbreak last?
A bladder diverticulum is a structural abnormality, not an outbreak. The duration of symptoms depends on the size of the diverticulum, the presence of complications (like infection or obstruction), and the effectiveness of treatment. Symptoms may be chronic and persistent if the diverticulum is not addressed. UTI outbreaks can last for days to weeks without treatment.
How is it diagnosed?
Cystoscopy: A thin, flexible tube with a camera is inserted into the bladder to visualize the diverticulum.
Voiding cystourethrogram (VCUG): X-ray of the bladder taken while urinating.
Ultrasound: Can visualize the bladder and may detect a diverticulum.
CT scan or MRI: May be used to evaluate the bladder and surrounding structures.
Urodynamic studies: To assess bladder function, especially if neurogenic bladder is suspected.
Timeline of Symptoms
Symptoms can develop gradually or suddenly, depending on the cause and size of the diverticulum. There is no standard timeline. The timeline might include:
Early stages: May be asymptomatic or have mild urinary frequency/urgency.
Progressive stages: Increased urinary frequency, urgency, difficulty urinating, feeling of incomplete emptying. UTIs may become more frequent.
Advanced stages: Urinary retention, hematuria, abdominal pain, kidney stones.
Important Considerations
Not all bladder diverticula require treatment. Small, asymptomatic diverticula may only need to be monitored.
Surgical removal of the diverticulum (diverticulectomy) may be necessary for large diverticula or those causing significant symptoms or complications.
If the diverticulum is caused by bladder outlet obstruction, the obstruction should be addressed in addition to or instead of removing the diverticulum.
Long-term follow-up is often needed to monitor for recurrence or complications.
Consult a urologist for diagnosis and management.