The transperitoneal removal of certain vesical diverticula and a radiographic technique for diagnosis.

Abstract

SUMMARYThe transperitoneal removal of certain medium‐sized and large vesical diverticula is a valuable alternative to other methods of removal; there is less trauma to the bladder than in extra peritoneal or transvesical methods of removal, since not only can the sac be excised without opening the bladder but only a relatively small area of the bladder wall requires dissection. The possibility of infecting the general peritoneal cavity may formerly have been an important argument against the use of this route, especially in patients who had had repeated catheterisation resulting in cystitis. In our clinics the great majority of prostate patients in recent years have either been admitted with acute retention without a catheter having been passed, or have been investigated in the out‐patient clinics and have had no instrumentation prior to immediate pre‐operative cystoscopy; the urine in consequence is usually free from infection. Moreover, the greater control of infection in the urinary tract, should it exist, by the use of antibiotics and sulphonamides, has made the urologist much less fearful of opening the peritoneal cavity for operation on the bladder than used to be the case. The radiographic technique described has proved a valuable aid in the selection of cases for the transperitoneal operation. Ten successful cases of transperitoneal diverticulectomy have been described.