Bladder Diverticulectomy With Stone Removal

The presence of stone(s) in a bladder diverticulum can be a cause of recurrent urinary tract infection, or outflow of obstruction and may require diverticulectomy. In a large diverticulum, with history of infection or in a location close to ureter, bilateral ureteral catheterization or double J stenting is preferred. The dissection is started from the most prominent part of the diverticulum, proceeding toward the diverticulum neck. However, sometimes it is difficult to expose the diverticulum. Traction with a grasping forceps at the edge of the diverticulum mouth helps in subsequent dissection with the twist-and-roll technique. It should be kept in mind that course of the ureter is distorted, increasing chances of injury. Stones from inside the diverticular cavity are removed and diverticular wall is excised. The bladder is closed with interrupted intracorporeal 2-0 Vicryl sutures.

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