Lower Urinary Tract Symptoms Produced by a Large Congenital Urinary Bladder Diverticulum: Surgical Decision Challenged?

Abstract

Abstract Urinary bladder diverticula represent herniation of the urothelium through muscularis propria of the urinary bladder wall. Bladder diverticula do not contain a defined functional muscularis propria layer and therefore empty poorly with micturition. In the adult, bladder diverticula are often associated with bladder outlet obstruction or neurogenic vesicourethral dysfunction. Congenital bladder diverticula are usually solitary, associated with a smooth-walled bladder, and occur in the absence of bladder outlet obstruction. Bladder diverticula are most often diagnosed incidentally during the evaluation of nonspecific lower urinary tract symptoms or infection. We present the case report of a very large congenital diverticulum of the urinary bladder (probably aggravated by bladder outlet obstruction), presented in a 75-year-old man with symptoms of urinary obstruction, leading to chronic retention, frequency, and recurrent urinary tract infections.