Don’t be intimidated by the long Latin word. A diverticulum is an outpouching in the bladder, when an abnormal sac or pouch forms at a weak point in the bladder wall. It can be congenital, as in present at birth, or it can develop later in life.
Normally, the bladder is relaxed when it is either empty or filling. When the bladder is full, the brain sends signals to the musculature of the bladder wall to contract and the sphincters to relax, thereby allowing urine flow. We often see bladder diverticulum in elder men with BPH issues (enlarged prostate). When the prostate is enlarged it can obstruct the urethra, making urination difficult. Men often experience urinary retention, straining, weak stream, urgency, and frequency. Under high pressures, the bladder wall weakens. It is rare to see this condition in women. As the pressure continues to rise little pockets develop in the bladder wall—also known as diverticula.
Bladder diverticula are usually asymptomatic; however they can show up as urinary tract infections and blood in the urine. Bladder diverticula commonly show up on imaging machines such as CTs or ultrasounds. At our office we can perform a cystoscopy to look in the bladder to identify these pockets.
According to the American Urological Association, “Bladder diverticula don’t always need to be treated if they’re not causing any problems.”
Bladder diverticula are typically treated when we take care of the underlying issue: the prostate. For men with BPH, we can use medications to relax the prostate smooth muscle and the bladder neck, or shrink the prostate. These will help improve urine flow and reduce bladder obstruction. For small bladder diverticulum, we usually monitor. If there are recurring UTIs, bladder stones, or retention issues then surgery is sometimes indicated.
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