ISSN 2398-2969      

Bladder: diverticulum

icanis
Contributor(s):

Victoria Lipscomb

Synonym(s): Vesicourachal diverticulum


Introduction

  • Vestigial outpouching of bladder wall at urachal attachment, may be incidental surgical or radiographic finding.
  • Signs: dysuria, hematuria, asymptomatic.
  • Diagnosis: positive contrast cystography (without distending the bladder).
  • Treatment: may resolve with medical treatment of concurrent urinary tract infection. May additionally require surgical excision of the affected area: diverticula may be difficult to identify in the deflated bladder at surgery.
  • Prognosis: predisposes to chronic urinary tract infection and urolithiasis.

Pathogenesis

Etiology

  • Urachus allows communication between urinary bladder and allantoic sac in fetus.
  • At birth, urachus is non-functional and all urine flows through urethra in normal animals.
  • There are 2 clinical syndromes:
    • Congenital macroscopic vesicourethral diverticula may persist.
    • Commonly remain clinically undetected until lower urinary tract infection develops.

Specific

  • Concurrent urinary tract infection Cystitis and/or cystic calculi.

Pathophysiology

  • Vestigial outpouching of bladder wall at urachal attachment (cranioventral pole of bladder).
  • Diverticulum can lead to the failure to void all urine from bladder → development of urinary tract infection → scarring of bladder wall → increased risk of urinary tract infection.

Timecourse

  • Months to years.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Scheepens E T F & L'Eplattenier H (2005) Acquired urinary bladder diverticulum in a dogJSAP 46 (2), 578-581 PubMed.
  • Lulich J P, Osbourne C A & Johnston G R (1989) Non-surgical correction of infection-induced struvite uroliths and a vesicourachal diverticulum in an immature dog. JSAP 30 (11), 613-617 VetMedResource.
  • Wilson J W, Klausner J S, Stevens J B & Osbourne C A (1979) Canine vesicourachal diverticula. Vet Surg (3), 63-67 Wiley Online Library.

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