Indications For Urologic Intervention

The diagnosis of a calyceal diverticulum in itself is not an indication for surgery, because most lesions are found incidentally. However, urologic intervention is warranted if a patient becomes symptomatic as a result of the calyceal diverticulum.

Passive filling and poor drainage of urine from the diverticulum lead to focal urinary stasis, which may result in urinary tract infection and calculus formation, and therefore intermittent or persistent flank pain and gross hematuria. Recurrent infections or hematuria should be localized to the side of the lesion, prior to definitive intervention. Rarely, large calyceal diverticula may cause ischemic or obstructive renal damage, and nephrectomy may be required (2).

Because it is lined with urothelium, a calyceal diverticulum may potentially harbor urothelial carcinoma, although this is exceedingly rare (5,6).

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