• Scand J Urol · Apr 2018

    Comparative Study

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

    • Mauro Pacella, Guglielmo Mantica, Massimo Maffezzini, Matteo Justich, Paolo Traverso, Paolo De Angelis, Fabio Gallo, Hilgard Ackermann, Stefano Zaramella, and Carlo Terrone.
    • a Department of Urology , Ospedale Policlinico San Martino, Istituto di Ricerca e Cura a Carattere Scientifico per l'oncologia, University of Genova , Genoa , Italy.
    • Scand J Urol. 2018 Apr 1; 52 (2): 134-138.

    ObjectiveThe treatment of bladder diverticula consists of diverticulectomy, mainly by a laparoscopic approach or transurethral resection of the diverticular neck and fulguration of the mucosa. The endoscopic approach is generally dedicated to small diverticula. The aim of this study was to compare laparoscopic diverticulectomy versus endoscopic fulguration for bladder diverticula larger than 4 cm.Materials And MethodsA retrospective review of the medical records of consecutive patients undergoing endoscopic or laparoscopic treatment for bladder diverticula larger than 4 cm at two tertiary hospitals was performed. Therapeutic success was defined as either complete resolution or a decrease of at least 80% in the size of the diverticulum. Complications were recorded and graded according to the Clavien-Dindo classification.ResultsAll patients were treated with transurethral resection of the prostate in the same operative session. The endoscopic group included a cohort of 20 male patients. The median age, diverticular diameter and operative time were 65 years, 7 cm and 62.5 min, respectively. No early postoperative complications were observed. Therapeutic success was achieved in 15 cases (75%). The laparoscopic group included a cohort of 13 male patients with a median age of 63 years and median diverticular diameter of 7.0 cm. The median operative time was 185 min (p < 0.0001). Two grade III postoperative complications were observed (15.3%). Therapeutic success was achieved in all patients (100%).ConclusionsAcquired bladder diverticula larger than 4 cm can be effectively managed either by a laparoscopic approach or by endoscopic fulguration.

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