What's the most likely diagnosis?

• Cystogram of a 21 year-old male with dysuria

1. Bladder ears
2. Carcinoma of the bladder
3. Ingested foreign body
4. Colonic fistula
5. Bladder diverticula

Answer:

 

5. Bladder diverticula

 

 

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Bladder Diverticula

General Considerations

• Uncommon
• May be congenital or acquired
  • Congenital (Hutch diverticula) are usually solitary
• More common in males
• Acquired arise from obstruction, infection or are iatrogenic
• More common than congenital
• Multiple
• Bladder is usually trabeculated
• Congenital arise from herniation of the mucosa through the musculature of the bladder wall
• Can become larger than bladder
• Usually occur lateral and superior to openings of ureters
• Single diverticula on one or both sides of bladder may be an incidental finding but multiple diverticula on the same side suggests an underlying condition

 

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