DIVERTICULUM OF THE BLADDER

Definition of Bladder Diverticulum

A bladder diverticulum is a pouch-like protrusion of the bladder wall that can occur in any part of the bladder.

Types of Bladder Diverticulum

• Congenital Bladder Diverticulum: It occurs during fetal development.
• Acquired Bladder Diverticulum: It occurs due to increased intra-vesical pressure.

Pathology of Bladder Diverticulum

Bladder diverticulum is characterized by:

• Outpouching of the bladder wall: Due to herniation of perivesical connective tissue.
• Thin-walled diverticulum: Diverticulum wall is thin and has a small blood supply.
• Increased risk of complications: Due to thin wall, increased risk of rupture and urinary tract infections.

Causes of Bladder Diverticulum

• Increased intra-vesical pressure: Due to benign prostatic hyperplasia, bladder outlet obstruction, or urethral stricture.
• Weakness of the bladder wall: Due to congenital or acquired factors.

Clinical Features of Bladder Diverticulum

• Asymptomatic: Many cases are asymptomatic.
• Urinary frequency and urgency: Due to increased bladder capacity.
• Urinary incontinence: Due to overflow incontinence.
• Dysuria: Painful urination due to infection or stone formation.
• Mass in the suprapubic region: Visible diverticulum.

Complications of Bladder Diverticulum

• Urinary tract infections: Due to stagnation of urine.
• Diverticulum rupture: Leading to peritonitis or retroperitoneal hematoma.
• Bladder stone formation: Due to stagnation of urine.

Investigations of Bladder Diverticulum

• Cystoscopy: To visualize the bladder and diverticulum.
• Ultrasound: To assess diverticulum size and bladder function.
• Intravenous urography: To assess urinary tract anatomy and function.
• Voiding cystourethrogram: To assess urine flow and diverticulum size.

Management of Bladder Diverticulum

• Conservative management: For asymptomatic cases.
• Surgical management: For symptomatic cases or complications.
• Endoscopic management: For small diverticula or urethral stricture.

Treatment of Bladder Diverticulum

• Diverticulectomy: Surgical removal of the diverticulum.
• Bladder augmentation: To increase bladder capacity.
• Urinary diversion: To relieve obstruction.

Homoeopathic Therapeutic Medicines for Bladder Diverticulum

• Calcarea carbonica: For weakness of the bladder wall.
• Lycopodium clavatum: For increased intra-vesical pressure.
• Nux vomica: For urinary frequency and urgency.
• Sabadilla: For urinary incontinence and overflow incontinence.