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Ho MC, Hashim H. Surveillance and Management of Bladder Diverticulum in the Setting of Bladder Outlet Obstruction. CURRENT BLADDER DYSFUNCTION REPORTS 2022. [DOI: 10.1007/s11884-022-00664-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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2
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Abdulrahman SA, Muhammad I, Abdulrahman A, Raslan K, Alshehabi Z. Urothelial carcinoma arising within a congenital bladder diverticulum in an adult male: A rare case report and literature review. Ann Med Surg (Lond) 2022; 77:103666. [PMID: 35638012 PMCID: PMC9142640 DOI: 10.1016/j.amsu.2022.103666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction and importance Neoplasms arising from vesical diverticula are rare clinical entities known as intradiverticular bladder tumors. The bladder diverticulum harboring these tumors can be congenital or acquired. Congenital diverticula are predominantly found in children and are extremely rare in adults. Case presentation A 56-year-old male admitted to our hospital with a 10-days history of painless gross hematuria and blood clots. Physical examination and vital signs were unremarkable. Radiologic examination revealed a bladder diverticulum with a mass inside it. Pathological examination confirmed the diagnosis of TCC tumor arising from congenital bladder diverticula. Clinical discussion While intradiverticular bladder tumors account for only 1% of all bladder tumors، and the finding of a congenital bladder diverticulum is a rare anomaly in adults, the concurrence of a tumor arising within a congenital bladder diverticulum is almost non-existent in adults. Conclusion We aimed to present a rare case of urothelial carcinoma arising from a congenital diverticulum in an adult while highlighting the diagnostic and therapeutic options used in managing such tumors. Congenital diverticula are predominantly found in children and are extremely rare in adults. The concurrence of a tumor arising within a congenital bladder diverticulum is almost non-existent in adults. Physicians should always consider the possibility of tumors developing within these diverticula.
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Affiliation(s)
- Seif-Aldin Abdulrahman
- Faculty of Medicine, Cancer Research Center, Tishreen University, Latakia, Syria
- Corresponding author.
| | - Ibrahim Muhammad
- Faculty of Medicine, Cancer Research Center, Tishreen University, Latakia, Syria
| | - Ali Abdulrahman
- Faculty of Medicine, Cancer Research Center, Tishreen University, Latakia, Syria
| | - Khidr Raslan
- Department of Urology, Tishreen University Hospital, Latakia, Syria
| | - Zuheir Alshehabi
- Department of Pathology, Cancer Research Center, Tishreen University, Latakia, Syria
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Malik DG, Ferrigni RG, Yang M. Identification of Bladder Diverticular Stone on 99mTc-Methyl Diphosphonate Bone Scintigraphy and SPECT/CT. J Nucl Med Technol 2020; 48:384-385. [DOI: 10.2967/jnmt.120.245175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/14/2020] [Indexed: 11/16/2022] Open
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Voskuilen CS, Seiler R, Rink M, Poyet C, Noon AP, Roghmann F, Necchi A, Aziz A, Lavollé A, Young MJ, Marks P, Saba K, van Rhijn BW, Fransen van de Putte EE, Ablat J, Black PC, Sosnowski R, Dobruch J, Kumar P, Jallad S, Catto JW, Xylinas E, Hendricksen K. Urothelial Carcinoma in Bladder Diverticula: A Multicenter Analysis of Characteristics and Clinical Outcomes. Eur Urol Focus 2020; 6:1226-1232. [DOI: 10.1016/j.euf.2018.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/27/2018] [Accepted: 12/04/2018] [Indexed: 02/07/2023]
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Moussa M, Abou Chakra M. Urothelial carcinoma arising from a bladder diverticulum containing multiple stones: A case report. Urol Case Rep 2018; 20:80-82. [PMID: 30035095 PMCID: PMC6052197 DOI: 10.1016/j.eucr.2018.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/08/2018] [Accepted: 07/10/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- M Moussa
- Urology Department, Zahraa University Hospital, Beirut, Lebanon
| | - M Abou Chakra
- Faculty of Medical Sciences, Department of Urology, Lebanese University, Beirut, Lebanon
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Iscaife A, Dos Anjos G, Barbosa C, Nahas WC, Srougi M, Antunes AA. The role of bladder diverticula in the prevalence of acute urinary retention in patients with BPH who are candidates to surgery. Int Braz J Urol 2018; 44:765-770. [PMID: 29617085 PMCID: PMC6092655 DOI: 10.1590/s1677-5538.ibju.2017.0605] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/06/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: The urinary bladder diverticula (BD) secondary to benign prostatic hyperplasia (BPH) is a complication that can lead to urinary stasis, stone, urinary tract infection (UTI) and tumors. It's role in acute urinary retention (AUR) is not totally understood. Objectives: To determine the effect of BD size on AUR rates in patients with BPH candidates to surgery. Subjects and Methods: We performed a retrospective cohort study of 47 patients with BPH and BD who underwent BPH surgery associated to complete bladder diverticulectomy from 2006 to 2016. We analyzed risk factors for AUR in patients with BD using univariate, multivariate and correlation analysis. Results: There was a difference in the size of the diverticula, with 6.8 cm vs. 4.5 cm among patients with and without AUR respectively (p=0.005). The ROC curve showed a correlation between the size of BD and the risk of AUR. The value of 5.15 cm presented a sensitivity of 73% and a specificity of 72%. The area under the curve was 0.75 (p=0.01). Comparing groups with BD >5.0 cm vs. ≤5.0 cm, the AUR incidence was 74% and 27.8% respectively with an OR of 2.65 (1.20-5.85) (p=0.005). In the multivariate analysis, only the size of the diverticula reached statistical significance (p=0.012). Conclusions: The diameter of BD is an independent risk factor for AUR in patients with BPH and BD who are candidates to surgery. A diameter greater than 5.15 cm increases the risk of AUR.
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Affiliation(s)
- Alexandre Iscaife
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil
| | - Gabriel Dos Anjos
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil
| | - Cristovão Barbosa
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil
| | - Willian Carlos Nahas
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil
| | - Miguel Srougi
- Divisão de Urologia, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil
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Yuce I, Ogul H, Eren S, Bayraktutan U, Kantarci M, Yalcin A. Vesicoenteric fistula caused by bladder diverticulitis: MRI Findings. Int Braz J Urol 2015. [PMID: 26200559 PMCID: PMC4752159 DOI: 10.1590/s1677-5538.ibju.2013.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ihsan Yuce
- Department of Radiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Hayri Ogul
- Department of Radiology, Ataturk University Medical Faculty, Erzurum, Turkey
| | - Suat Eren
- Department of Radiology, Ataturk University Medical Faculty, Erzurum, Turkey
| | | | - Mecit Kantarci
- Department of Radiology, Ataturk University Medical Faculty, Erzurum, Turkey
| | - Ahmet Yalcin
- Department of Radiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
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8
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Hu B, Satkunasivam R, Schuckman A, Miranda G, Cai J, Daneshmand S. Urothelial carcinoma in bladder diverticula: outcomes after radical cystectomy. World J Urol 2014; 33:1397-402. [DOI: 10.1007/s00345-014-1472-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 12/22/2014] [Indexed: 11/30/2022] Open
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10
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The spectrum of histopathologic findings in vesical diverticulum: implications for pathogenesis and staging. Hum Pathol 2013; 44:1223-32. [DOI: 10.1016/j.humpath.2012.11.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 11/19/2012] [Accepted: 11/21/2012] [Indexed: 11/19/2022]
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11
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Transitional Cell Carcinoma within a Portion of Inguinally Herniated Bladder. Case Rep Urol 2013; 2013:610312. [PMID: 23781387 PMCID: PMC3676974 DOI: 10.1155/2013/610312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 05/15/2013] [Indexed: 11/18/2022] Open
Abstract
Bladder herniation within the inguinal canal is a relatively uncommon finding. We report an even less-common occurrence of transitional cell carcinoma located within a portion of inguinally herniated bladder. Fewer than 20 reports exist in the literature describing this scenario.
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12
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Tumeurs de vessie intradiverticulaires : revue du Comité de cancérologie de l’Association française d’urologie. Prog Urol 2012; 22:495-502. [DOI: 10.1016/j.purol.2012.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 03/02/2012] [Accepted: 03/26/2012] [Indexed: 11/23/2022]
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13
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Roslan M, Markuszewski MM, Kłącz J, Krajka K. Laparoendoscopic single-port transvesical diverticulectomy: preliminary clinical experience. J Endourol 2012; 26:975-9. [PMID: 22332668 DOI: 10.1089/end.2011.0550] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE We present our single-center experience with three patients who were undergoing laparoendoscopic single-site (LESS) diverticulectomy through a single-port device introduced directly into the bladder. PATIENTS AND METHODS During March and April 2011, we operated on three men aged 62 to 76 years (mean 67 y) for symptomatic bladder diverticula using a standard lithotomy position and general anesthesia. The procedure was performed transvesically (percutaneous intraluminal approach) with a single-port device (four-channel) via a 1.5-cm incision made 2 cm above the pubic symphysis. Standard 10-mm optic and rigid laparoscopic instruments were used. The defect of the bladder wall was closed with an absorbable 3/0 running V-Loc suture. An 18F Foley catheter was left for 4 to 7 days. RESULTS The average operative time was 128 minutes (range 80-175 min). The blood loss was minimal. Patients were discharged on the third postoperative day with no intra-, nor postoperative complications. The 3-month follow-up confirmed good operative results in all cases. CONCLUSION We consider laparoendoscopic single-port transvesical excision of bladder diverticulum as a feasible and safe procedure and a valuable treatment option for bladder diverticulectomy.
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Affiliation(s)
- Marek Roslan
- Department of Urology, Medical University of Gdańsk, Gdańsk, Poland.
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Abstract
Diverticula are commonly seen in hollow viscous organs. One common complication of diverticula is infection, known as diverticulitis. Although diverticulitis has been extensively described with respect to the colon, not many cases describe diverticulitis of the urinary bladder. We report a case of diverticulitis of the bladder to emphasize the imaging findings on PET/CT and to discuss management and possible complications.
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15
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Blaivas JG, Chughtai B, Tsui JF, Laudano M. Management of Bladder Diverticula. CURRENT BLADDER DYSFUNCTION REPORTS 2011. [DOI: 10.1007/s11884-011-0108-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Tortorelli AP, Rosa F, Papa V, Alfieri S, Doglietto GB. Giant bladder diverticulum. Updates Surg 2011; 63:63-6. [PMID: 21229344 DOI: 10.1007/s13304-010-0042-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 12/30/2010] [Indexed: 11/25/2022]
Abstract
We present the case of a 73-year-old man affected by progressive and painful abdominal distension and paresthesia/hypoesthesia at the left leg. US and CT-scan revealed the presence in the left retroperitoneum of a large cystic mass without parietal thickening or enhancement after contrast injection. This mass disappeared after positioning a vesical Foley's catheter and a retrograde cystography confirmed the suspected diagnosis of a large bladder diverticulum due to a severe prostatic hypertrophy; the patient underwent an open diverticulectomy and endoscopic prostatic resection. Bladder diverticula can occasionally appear as complex pelvic masses not obviously connected to the bladder, eventually leading to diagnostic confusion; while small size diverticulum resolves with relief of bladder outlet obstruction, open or laparoscopic diverticulectomy is needed in large size diverticulum if symptomatic, even considering the possible tumor harboring.
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Affiliation(s)
- Antonio Pio Tortorelli
- Digestive Surgery, "A. Gemelli" Hospital, Catholic University, Largo A. Gemelli, Rome, Italy
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Bladder diverticulitis: a case report. Case Rep Emerg Med 2011; 2011:303498. [PMID: 23326691 PMCID: PMC3542896 DOI: 10.1155/2011/303498] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Accepted: 07/27/2011] [Indexed: 11/29/2022] Open
Abstract
Bladder diverticulum, an outpouching of the mucosa through the muscular wall of the bladder, is a multifactorial disease process that can be either acquired or congenital. Although small diverticuli are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation. We describe the case of an elderly gentleman who presented to the emergency department with abdominal pain and was ultimately diagnosed with bladder diverticulitis, a disease not previously described in the literature.
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19
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Treatment of bladder diverticula, impaired detrusor contractility, and low bladder compliance. Urol Clin North Am 2009; 36:511-25, vii. [PMID: 19942049 DOI: 10.1016/j.ucl.2009.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bladder diverticula are common enough to be encountered by most urologists in practice but are reported less frequently in the literature than they were 50 years ago. Some patients can be managed nonoperatively, whereas others will need surgical intervention consisting of bladder outlet reduction and possibly removal of the diverticulum itself. In addition to the decision to operate, the timing of each intervention deserves careful consideration. Cystoscopy, computed tomography with contrast, urodynamic studies, cytology, and voiding cystourethrography play important roles in informing the clinician. Many new techniques for treatment of the bladder outlet and the diverticulum are available, such as laparoscopy and robotic surgery.
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Affiliation(s)
- Chandan J Das
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.
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21
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Das CJ, Debnath J, Thulkar SP, Kumar L, Vashist S. Transitional cell carcinoma in a herniated vesical diverticulum. Br J Radiol 2007; 80:e227-9. [DOI: 10.1259/bjr/68501519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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22
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Wang CK, Chueh SC. Case Report: Laparoscopic Partial Cystectomy with Endo-GIA Stapling Device in Bladder Diverticular Carcinoma. J Endourol 2007; 21:772-5. [PMID: 17705769 DOI: 10.1089/end.2006.0348] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND PURPOSE The incidence of bladder diverticular carcinoma is low, ranging from 0.8% to 10%. Traditionally, treatment consisted of open surgical excision or transurethral resection. More recently, laparoscopic surgery has become widely accepted. We report here a case of bladder diverticular carcinoma treated with laparoscopic partial cystectomy. CASE REPORT A 56-year-old man presented with gross hematuria and was found to have transitional-cell carcinoma in a bladder diverticulum. We performed transurethral resection of the tumors and laparoscopic partial cystectomy. A 45-mm Endo-GIA stapler (U.S. Surgical Corp., Norwalk, CT) was used for direct resection of the diverticular tissue, and the specimen was removed en bloc. Suture of the seromuscular layer was performed with the intracorporeal knotting technique. Lymph-node dissection also was performed. At 3-month follow-up, it was noted that there was tumor recurrence that was not at the original diverticular site, and transurethral resection was carried out. After 1 year, cystoscopy and CT scans showed neither recurrence nor metastasis. No encrustation or erosion was induced by the staples. CONCLUSION Laparoscopic partial cystectomy can be an alternative treatment for bladder diverticular carcinoma.
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Affiliation(s)
- Chun-Kai Wang
- Department of Urology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
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Haecker A, Riedasch G, Langbein S, Alken P, Michel MS. Diverticular carcinoma of the urinary bladder: diagnosis and treatment problems. A case report. Med Princ Pract 2005; 14:121-4. [PMID: 15785107 DOI: 10.1159/000083925] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2003] [Accepted: 09/08/2003] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To report a case of a primary carcinoma arising in a vesical diverticulum. CLINICAL PRESENTATION AND INTERVENTION A 59-year-old male patient presented with painless macrohematuria. A primary carcinoma arising in a vesical diverticulum was detected with cystoscopy and confirmed with rectal endosonography and computer tomography. and radical cystoprostatovesiculectomy with ileal conduit was performed. Chemotherapy with cisplatin and methotrexate followed. The patient died of an acute cardiac event in the 4th postoperative month. CONCLUSION This report illustrates that in a case of a closed opening of a bladder diverticulum, rectal endosonography and computer tomography do provide additional support for making a diagnosis of a hidden tumor in the diverticulum.
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Affiliation(s)
- Axel Haecker
- Department of Urology, University Hospital Mannheim, Germany.
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Filiadis I, Hastazeris K, Tsimaris I, Papadopoulos A, Kakoulidis S, Stavropoulos NE. Simultaneous adenomectomy and preperitoneal repair of inguinal hernias by a single incision with the application of polypropylene mesh. Int Urol Nephrol 2003; 35:19-24. [PMID: 14620277 DOI: 10.1023/a:1025976720778] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Preperitoneal inguinal herniorraphy in conjuction with other pelvic procedures has been described in the literature, but it has not gained wide popularity mainly due to the high recurrence rate. Recently, there has been a resurgence of interest in the preperitoneal repair of inguinal hernias with the application of mesh on the deficiency of the inguinal wall using the method commonly known as the Stoppa procedure. We evaluated the results and complications of 22 patients who underwent open surgical prostatectomy (adenomectomy) and simultaneous preperitoneal application of polypropylene mesh. Nineteen (86.4%) patients suffered from unilateral inguinal hernia whereas the remaining 3 (13.6%) had bilateral protrusions. Primary hernias only and not recurrences were included in our series. The median clinical follow-up was 20.4 months (range 9-50 months). The hernioplasty itself prolonged the whole procedure for only a few minutes and it did not affect the patients' hospitalization time (mean 6.7 days). Wound infection with subsequent development of cutaneous fistula occurred in one patient (4.5%) and treated conservatively. During follow-up one recurrence (4.5%) at the side of the previous repair of the left inguinal hernia was recorded; the protrusion was insignificant and left untreated. In all but one patient (21/22, 95.5%), the surgical results were excellent. In our experience, simultaneous transvesical adenomectomy and mesh preperitoneal hernioplasty is a convenient and safe procedure which can easily be performed by urologists in just a few minutes. The procedure which is both cost and time effective for the surgeon, achieves long-lasting beneficial results for the vast majority of patients.
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Affiliation(s)
- I Filiadis
- Department of Urology, General Hospital of Kavala, Kavala, Greece.
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Golijanin D, Yossepowitch O, Beck SD, Sogani P, Dalbagni G. Carcinoma in a Bladder Diverticulum: Presentation and Treatment Outcome. J Urol 2003; 170:1761-4. [PMID: 14532771 DOI: 10.1097/01.ju.0000091800.15071.52] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE In this retrospective review we characterize the outcomes of patients treated for transitional cell carcinoma in a bladder diverticulum. MATERIALS AND METHODS Between 1986 and 2001, 39 patients were treated for tumors in a bladder diverticulum. All patients underwent initial transurethral resection of the tumor. Based on cystoscopic evaluation, bimanual examination and computerized tomography findings, tumors were classified as superficial (Ta, Tis), superficially invasive confined to diverticulum (T1) or extra diverticular (T3+). Patients with superficial or superficially invasive disease were treated either conservatively with repeat transurethral resection, or with partial or radical cystectomy. Patients with extra diverticular extension were treated with partial or radical cystectomy when amenable to surgical extirpation. Predictors of outcome were assessed by univariate and multivariate analyses. End point was overall and disease-specific survival. RESULTS Of our cohort of 39 patients 13 (33%) presented with superficial disease, 13 (33%) with superficially invasive tumors and 13 (33%) with invasive (extra diverticular) disease. Actuarial 5-year disease specific survival for the cohort was 72 +/- 5.4%. Significant differences in 5-year disease specific survival were observed among patients presenting with superficial tumors (83 +/- 9%), superficially invasive tumors (67 +/- 7%) and extra diverticular disease (45 +/- 14%). Of the patients presenting with T1 tumors the primary mode of treatment did not correlate with outcome. In a multivariate model clinical staging was the only independent predictor of outcome and concomitant carcinoma in situ reached borderline significance. CONCLUSIONS Our data support a conservative approach for tumors confined to the bladder diverticulum, provided complete removal is feasible and close surveillance ensues.
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Affiliation(s)
- Dragan Golijanin
- Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Abstract
A rare case of clear cell adenocarcinoma within a bladder diverticulum is presented. A 69-year-old man presented to our institution with gross hematuria. Workup, including computed tomography and cystoscopy, revealed a papillary bladder mass within a bladder diverticulum near the right ureteral orifice. Biopsy of the tumor was performed, and the pathologic examination revealed clear cell adenocarcinoma. He underwent bladder diverticulectomy and remained disease free at 1 year of follow-up. The clinicopathologic characteristics of this entity compared with its most difficult pathologic differential diagnosis, nephrogenic adenoma, are reviewed.
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Fekak H, Rabu R, Joual A, Bennani S, Moufid K, Sarf S, Debragh A, el Mimu M, Benjelloun S. [Intradiverticular bladder tumors. Three case reports]. ANNALES D'UROLOGIE 2002; 36:53-7. [PMID: 11859579 DOI: 10.1016/s0003-4401(01)00072-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The bladder tumours in vesical diverticula is rare, and the poor prognosis, because it was often with early invasion. We reported three cases of bladder tumours in vesical diverticula, with delay of diagnosis two, eight and twelve months respectively. The radiology exploration suspected the diagnosis and the histology biopsy confirmed a diagnosis of primary transitional cell carcinoma in two cases: PTa GI and T2 GII, and in an other case it was a invasive epidermoid carcinoma. The first patient was dead by urethral resection of the bladder tumour. The second required a cytoprototectomy and the last patient. The treatment consisted of radiotherapy and chemotherapy. We insisted of the particularity diagnosis, histology and therapeutic for bladder tumour in vesical diverticula and the early diagnosis in order to have a good prognosis.
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Affiliation(s)
- H Fekak
- Service d'urologie, CHU Ibn Rochd, Casablanca, Maroc
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Abstract
OBJECTIVES To evaluate the treatment and prognosis of primary tumors in bladder diverticula. METHODS The cases of 611 patients treated for bladder tumors at a single medical center were retrospectively reviewed. RESULTS Eight patients had primary intradiverticular transitional cell carcinoma. Five patients had Stage Ta tumor, and 3 had Stage T1 tumor. Most patients were treated by local resection and adjuvant intravesical chemotherapy. All patients with initial Ta disease are disease free at the time of this writing. One patient with T1 disease died, 1 patient's disease recurred several times, and 1 patient showed positive cytology without apparent disease. CONCLUSIONS Superficial intradiverticular tumors may be treated conservatively. Routine cystoscopy for patients with a bladder diverticulum is warranted for early diagnosis of possible intradiverticular tumor.
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Affiliation(s)
- J Baniel
- Department of Urology, Rabin Medical Center (Beilinson Campus), Petach Tikva, Israel
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29
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Shah B, Rodriguez R, Krasnokutsky S, Shah SM, Ali Khan S. Tumour in a giant bladder diverticulum: a case report and review of literature. Int Urol Nephrol 1997; 29:173-9. [PMID: 9241544 DOI: 10.1007/bf02551338] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We report an unusual case of a transitional cell carcinoma arising in a bladder diverticulum presenting as a giant abdominal mass and acute urinary retention. We have reviewed the literature and discuss the aetiology, diagnosis, and treatment of tumours arising in vesical diverticula.
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Affiliation(s)
- B Shah
- Department of Urology, SUNY at Stony Brook, USA
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Iselin CE, Winfield HN, Rohner S, Graber P. Sequential laparoscopic bladder diverticulectomy and transurethral resection of the prostate. J Endourol 1996; 10:545-9. [PMID: 8972790 DOI: 10.1089/end.1996.10.545] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The surgical treatment of prostatic obstruction associated with a clinically significant bladder diverticulum has classically combined open diverticulectomy with relief of the bladder outlet obstruction. This report demonstrates that this result may be efficiently achieved by performing transurethral surgery followed immediately by laparoscopic excision of the diverticulum. As assessed by a retrospective comparison with four open bladder diverticulectomies combined with transurethral resection of the prostate, laparoscopic diverticulectomy markedly reduces the postoperative and convalescence period. The overall financial saving that ensues may benefit both the patient and the healthcare system. Sequential laparoscopic bladder diverticulectomy and transurethral resection of the prostate illustrates the increasing possibilities of minimally invasive surgery.
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Affiliation(s)
- C E Iselin
- Clinique d'Urologie, Département de Chirurgie, Hôpital Cantonal Universitaire, Geneva, Switzerland
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31
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Abstract
Both radical cystectomy and diverticulectomy for the treatment of neoplasms arising in a vesical diverticulum have resulted in poor survival, mainly secondary to early metastatic spread. In this study, nine patients were treated with a multispecialty approach in hopes of eradicating both local and distant disease. All patients underwent a combination of therapeutic modalities with three patients undergoing pre-operative radiotherapy (RT) and diverticulectomy; diverticulectomy and chemotherapy (three patients); diverticulectomy with chemotherapy and pre-operative RT (two patients); and definitive RT with cisplatin (one patient). With a mean follow-up of 4.0 years (median 3.2), four patients are free of disease, two are dead of other causes, one patient has developed an invasive recurrence, one patient is alive with metastatic disease, and one patient is dead of disease. Five patients (55%) developed local recurrences. Disease-specific survival for the group was 89%. Surgical monotherapy has been ineffective in controlling both local and metastatic disease in patients with diverticular tumors. This study suggests a significant benefit from systemic chemotherapy and RT when combined with surgery for these neoplasms.
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Affiliation(s)
- M G Garzotto
- Division of Urology, University of Florida, Gainesville 32610, USA
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Abstract
Nephrogenic adenoma is a rare proliferative response of urothelium to chronic irritation or infection. It has been reported to occur in various locations in the urinary tract, including the renal pelvis, ureter, bladder and urethra, and within an ileal conduit. We report our experience with this lesion occurring in a bladder diverticulum.
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Affiliation(s)
- J P Heffernan
- Department of Urology, Naval Medical Center, San Diego, California
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Parra RO, Jones JP, Andrus CH, Hagood PG. Laparoscopic diverticulectomy: preliminary report of a new approach for the treatment of bladder diverticulum. J Urol 1992; 148:869-71. [PMID: 1387421 DOI: 10.1016/s0022-5347(17)36748-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Laparoscopic techniques have expanded the possibilities of endo-surgically approaching urological abnormalities that would otherwise be managed via an open operation. We report on another useful application of the laparoscope, bladder diverticulectomy. A large bladder diverticulum, responsible for incomplete bladder emptying and recurrent urinary tract infections in an 87-year-old man, was successfully excised endoscopically. The technique and possible future indications are described.
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Affiliation(s)
- R O Parra
- Department of Surgery, St. Louis University School of Medicine, Missouri
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Abstract
A case of adenocarcinoma arising from a diverticulum of the bladder is reported. A review of literatures together with the local statistics is presented.
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Affiliation(s)
- K Y Lam
- Department of Pathology, Queen Mary Hospital, University of Hong Kong
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Lowe FC, Goldman SM, Oesterling JE. Computerized tomography in evaluation of transitional cell carcinoma in bladder diverticula. Urology 1989; 34:390-5. [PMID: 2595887 DOI: 10.1016/0090-4295(89)90451-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Between 1981 and 1985, 6 patients with transitional cell carcinoma in bladder diverticula had preoperative computerized tomography (CT). CT suggested no invasion through the wall of the diverticulum in all 5 patients who had pathologic confirmation. CT is a useful staging procedure and is helpful in determining the management of patients with transitional cell carcinoma.
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Affiliation(s)
- F C Lowe
- Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Carcinoma Primitivo in Diverticolo Vescicale: A Proposito Di Due Casi. Urologia 1988. [DOI: 10.1177/039156038805500105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ferrari P, Pollastri CA, Castagnetti G, Grassi D, De Donatis E, Ferrari G. Diverticoli Vescicali: Dieci Anni Di Esperienza. Urologia 1987. [DOI: 10.1177/039156038705400622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Melekos MD, Asbach HW, Barbalias GA. Vesical diverticula: etiology, diagnosis, tumorigenesis, and treatment. Analysis of 74 cases. Urology 1987; 30:453-7. [PMID: 3118548 DOI: 10.1016/0090-4295(87)90378-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A thirteen-year review of bladder diverticula was undertaken and 74 cases were identified. In 8 patients primary neoplasms arose in the diverticula, and their treatment included diverticulectomy or partial cystectomy with or without postoperative irradiation, irradiation only, and transurethral resection of the tumor combined with fulguration of the diverticular wall and postoperative bladder instillations with doxorubicin or thiotepa solutions. Early diagnosis with additional visualization of the interior of vesical diverticulum is mandatory, since carcinoma arising in it has a poor prognosis.
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Affiliation(s)
- M D Melekos
- Department of Urology, Patras University, School of Medicine, Greece
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