BLADDER DIVERTICULAE (BD) CONGENITAL OR ACQUIRED?

Abstract

We describe 33 patients (11 males, with ages less, than 13 years) having BD which were found during radiologic examination of urinary tract infection (UT), vesico ureteral reflux(VUR), enuresis, hematuria and mictional pain. None had obstructive pathology of urethra nor neurogenic bladder disease. 26/33 were studied with ccitplex urodynamics( intravesical pressure, intraabdominal pressure perineal EMG, flow rate and simultaneous radioscopy). 20/26 had unstable bladder, expressed by uninhibited contractions(UIC). The distribution of the BD was: Single 15/33, Multiple 18/33, Bladder ceiling 4/33, Trigone 15/33, Bladder 10/33, Paraureterals 4/33. Existed preop. 26/33, appeared postop 7/33 (with UIC 7/7), Resected BD 2, Relapse postop 2/2 (with UTC 2/2). Significant pathology associated to div: Chronic Cystytis 13/33, UIC 20/26, Bladder Sphincter Disinergia 8/26, UI 24/33, VUR 26/33, Ureteroneocystostomias 12, Diverticulectomies 2, Postop Div. 7/33. From 26 VUR (bilateral 7/26, left 10/26, right 9/26) 15/26 had UIC. We believe that the frequent unstable bladder is an important factor in the genesis of BD. In these patients, UIC must be searched. If they exist, the possibility of relapsing is important. In other bladder surgeries it is a possible postop complication. 6/26 did not have UIC at the time of urodynamic evaluation, but they could have had the diverticulae years before the study.