Urinary bladder is a muscular sac, located in the pelvis. The main function of this organ is to collect urine excreted by the kidneys before disposing off through urination. Many people may have small pouches, called diverticula. Bladder diverticulitis is the condition that is caused by the formation of small pouches in the bladder wall. These pouches are known as diverticula. In most cases, people don’t notice the existence of diverticula in the bladder, unless the symptoms appear. Intestinal diverticulosis and bladder diverticulitis are almost the same conditions, as both are characterized by the formation of pouches. Diverticulosis is limited to the intestines and it doesn’t affect the bladder. Hence, both the conditions are unrelated.
Bladder diverticulum may be congenital or acquired. Congenital bladder diverticulitis is present from birth and it is characterized by the presence of a single pouch. Due to the weakened bladder wall, protrusions occur, which is usually found during childhood or prenatal ultrasound. If it doesn’t create any problems, no treatment is required.
Acquired bladder diverticulitis results from some kind of obstruction, such as urethra scarring, urethral stricture or enlarged prostate. It may also be caused due to bladder dysfunction or bladder surgery. Patient with bladder dysfunction or bladder surgery has multiple diverticula formed in the bladder wall. Acquired diverticula are usually multiple. Acquired bladder diverticulitis is typically found in elderly men and usually associated with benign prostatic hyperplasia (BPH).
Bladder diverticulitis usually does not exhibit any symptoms. However, it can cause the symptoms like urinary tract infection, urinary retention (urination inability), or hematuria (blood in urine).
Diagnosis and Treatment for Bladder Diverticulitis
Diverticula in bladder can be found incidentally when performing the imaging tests for other conditions. Various tests can be performed to detect the presence of bladder diverticulitis. An ultrasound is the initial test for early diagnosis to find out the basic abnormalities in the bladder. Other tests like cystogram, cytoscopy and urodynamics are also helpful in the confirmation of diagnosis.
Bladder diverticulitis usually doesn’t need any treatment, unless any problems arise due to the formation of pouches. The treatment can help to resolve the problems like bladder stones, tumors, recurrent infection or reflux that are associated with diverticulitis. The condition can be controlled by managing the symptoms. There may require a long-term medication treatment. In case of recurring infection, antibiotic therapy is recommended. To resolve urinary obstruction, the treatment aims at relief of obstruction and possible removal diverticulum. In some cases, surgery may be needed to remove the pouches. Both open and laparoscopic options are available for bladder diverticulitis surgery. The surgery may be difficult due to inflammation of chronic infection of diverticula. In patients who cannot undergo an open surgery, the diverticulum should be treated by enlarging its opening into the bladder.
The treatment generally gives excellent results and can give complete resolution of urinary symptoms. Most people find easy urination after surgery. Regular follow-up after surgery is necessary to ensure proper functioning of bladder. People, who undergo open surgery, may require catheter for 1-2 weeks. Some people may have poorly functioning bladder due to long-term obstruction. Such patients may require intermittent catheterization to empty the bladder.