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Large bladder diverticula: a comparison between laparoscopic excision and endoscopic fulguration.

Mauro Pacella1, Guglielmo Mantica1,2, Massimo Maffezzini1

  • 1a Department of Urology , Ospedale Policlinico San Martino, Istituto di Ricerca e Cura a Carattere Scientifico per l'oncologia, University of Genova , Genoa , Italy.

Scandinavian Journal of Urology
|January 9, 2018
PubMed
Summary

Laparoscopic diverticulectomy and endoscopic fulguration are effective treatments for large bladder diverticula (>4cm). Laparoscopic surgery achieved 100% success with complications, while endoscopic fulguration had 75% success with no early complications.

Keywords:
Bladder diverticulectomyTURPendoscopylaparoscopyprostate vaporization

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Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Bladder diverticula treatment options include diverticulectomy (laparoscopic) or transurethral resection.
  • Endoscopic approaches are typically for smaller diverticula.

Purpose of the Study:

  • Compare laparoscopic diverticulectomy and endoscopic fulguration for bladder diverticula exceeding 4 cm.
  • Evaluate therapeutic success and complication rates for both procedures.

Main Methods:

  • Retrospective review of patients with bladder diverticula >4 cm treated at two tertiary hospitals.
  • Therapeutic success defined as complete resolution or ≥80% size reduction.
  • Complications graded using the Clavien-Dindo classification.

Main Results:

  • Endoscopic group (20 patients): 75% therapeutic success, median operative time 62.5 min, no early complications.
  • Laparoscopic group (13 patients): 100% therapeutic success, median operative time 185 min, 15.3% grade III complications.

Conclusions:

  • Both laparoscopic diverticulectomy and endoscopic fulguration effectively manage acquired bladder diverticula >4 cm.
  • Laparoscopic approach demonstrated higher success rates but longer operative times and more complications.