[Laparoscopic extraperitoneal bladder diverticulectomy: an initial case report]

We report a case with a large bladder diverticulum caused by the bladder outlet obstruction, which was successfully treated with laparoscopic extraperitoneal diverticulectomy. The patient was a 71-year-old man, who had had dysuria, micturition pain and cloudy urine. We found the patient to have benign prostatic hyperplasia and a large diverticulum of the bladder. We removed the diverticulum by laparoscopic procedure and then the prostate by transurethral resection on September 24th, 1998. Before the diverticulectomy, we placed a ureteral stent in the left ureter and 8Fr Foley catheters in the diverticulum and bladder. A working space was made by dilation using a balloon dilator. After removing the diverticulum, we made 5 stitches to close the bladder wall. After the surgery, a 22Fr Foley catheter was placed and removed on the 9th postoperative day. Patient had a satisfactory micturition and was discharged on the postoperative 15th day. Laparoscopic diverticulectomy might be a modality for symptomatic bladder diverticulum, because it is minimally invasive and can completely remove bladder diverticulum.