Product Summary: AMA rates
Open excision of bladder diverticulum. Controversial procedure for the excision of a bladder diverticulum where there is bladder calculus and bladder function is compromised/
Item number: 37020, 105
Why is it done?
- This procedure is performed when all other treatment options are exhausted with recurrent symptoms.
- Symptoms include: a weak stream, nightly urination, frequent urination, inability to urinate, sudden cut-off of stream, (LUTS), recurrent bladder infections, recurrent bladder calculi (stones).
- Medication such as Flomaxtra, Xatral Minipress etc. should always be given as a first resort.
- Step-up therapy should have been used for prostates larger than 35-50cc with either Duodart, Avodart or Proscar and can be used as a first line in these huge prostates.
- A TURP may have been performed to dis-obstruct a huge prostate.
- Neurogenic causes of bladder dysfunction should be excluded by means of a Urodynamic study.
- Patient informed decision is vital.
- It provides a quicker solution with more marked side-effects and risks.
How is it done?
- Patients will receive a general anaesthesia, unless contra-indicated.
- Prophylactic anti-biotics is given.
- An indwelling catheter is placed and the bladder is filled with saline.
- A lower midline incision is made.
- The retropubic space of Retzuis is entered.
- The bladder is opened anteriorly in the midline.
- A Foleys catheter is placed in the diverticulum.
- The bladder incision is extended to the diverticulum. Diverticulum is excised.
- Special care is required for divericulae close to the ureters. Placement of ureteric catheters are done to prevent ureteric injury.
- Bladder is closed in 2 layers over a 3 way irrigation catheter.
- A drain is left for a couple of days.
- You may have continuous Antibiotics over the next few days.
- You will spend up to 5-7 nights in hospital.
- You will have a catheter for 14 days.
- A drain for 2-3 days.
- You will be discharged as soon as you are drain free, temperature free and have opened your bowels.
- You may initially suffer from urge symptoms caused by the catheter.
- There may be some blood in your urine. You can remedy this by drinking plenty of fluids until it clears.
- A ward prescription will be issued on your discharge, for your own collection at any pharmacy.
- A follow-up appointment will be scheduled for 2 weeksfor a cystogram.
- Should the cystogram confirm to urine leaks, your catheter will be removed.
- A review appointment is scheduled 6 weeks later.
- Don’t hesitate to ask Jo if you have any queries.
- DON’T SUFFER IN SILENCE, OR YOU WILL SUFFER ALONE!
- Rarely blood loss requiring blood transfusion.
- Prolonged hospital stay.
- Urine leak requiring prolonged catheterisation.
- NB! Each person is unique and for this reason symptoms vary!
Bladder Diverticulectomy (415 KB)