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Case Reports: Reminder of important clinical lesson
Bladder diverticulum caused by primary bladder neck obstruction
  1. Joanna Marantidis1,
  2. Rishabh Kumar Simhal1,
  3. Lambros Stamatakis1,2 and
  4. Rachael D Sussman1,2
  1. 1Department of Urology, MedStar Georgetown University Hospital, Washington, DC, USA
  2. 2Department of Urology, MedStar Washington Hospital Center, Washington, DC, USA
  1. Correspondence to Rishabh Kumar Simhal; rishi.simhal{at}gmail.com

Abstract

Here, we report a case of a patient in their mid 30s who presented with an elevated creatinine and was found to have a massive bladder diverticulum. The patient underwent a robotic-assisted diverticulectomy. They were later found to have a primary bladder neck obstruction on video urodynamics, and subsequently, underwent bladder neck incision, leading to significant improvement in urinary symptoms. Primary bladder neck obstruction is an overlooked cause of bladder diverticulum. While cystoscopy and cross-sectional imaging are frequently used in the initial evaluation of bladder diverticula, in the absence of an anatomic obstruction such as prostate enlargement, video urodynamics should be performed to assess for primary bladder neck obstruction.

  • urological surgery
  • urology

https://doi.org/10.1136/bcr-2021-247124

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    Footnotes

    • Twitter @rishi_simhal

    • Contributors RDS and JM contributed to the reporting and acquisition of data. LS contributed to the conception and acquisition of data. RDS contributed to the planning, conscription and editing of the case.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.