Transurethral endoscopic approach for large bladder diverticula: Evaluation of a large series

  • Mauro Pacella Department of Urology, Policlinico San Martino Hospital, University of Genova, Italy.
  • Nicolo' Testino Department of Urology, Policlinico San Martino Hospital, University of Genova, Italy.
  • Guglielmo Mantica | guglielmo.mantica@gmail.com Department of Urology, San Raffaele Turro Hospital, San Raffaele University, Milan, Italy.
  • Matteo Valcalda Department of Urology, Policlinico San Martino Hospital, University of Genova, Italy.
  • Rafaela Malinaric Department of Urology, Policlinico San Martino Hospital, University of Genova, Italy.
  • Carlo Terrone Department of Urology, Policlinico San Martino Hospital, University of Genova, Italy.

Abstract

Objective: To present the results of the largest series of patients with bladder diverticula > 4 cm managed with an endoscopic approach and give tips about the execution of the procedure.
Materials and methods: Data of male patients undergone the endoscopic approach for an acquired bladder diverticula > 4 cm from December 2004 to August 2018 were prospectively collected and retrospectively analyzed. The description of the monopolar and bipolar techniques are provided. The success of the procedure was defined as the reduction of the diverticula for more of the 80% of its initial diameter documented at the 3- months follow-up imaging. Continuous variables with nonparametric distribution were compared using the Mann-Whitney test, while frequencies of categorical variables were compared between groups by Fisher’s exact test with significance level set at 0.05.
Results: Thirty-nine patients with a mean (+/- SD) age at surgery of 69.4 ± 8.8 years were enrolled, for an equal number of diverticula managed. The mean diverticular size was 75.1 ± 24.5 millimeters. The mean operative time was 65 ± 21.9 minutes including the prostate surgery. Twelve patients (30.8%) were managed with bipolar energy, the others with monopolar. The success of the procedure was achieved in 30 patients (76.9% - 7 bipolar and 23 monopolar - p = 0.66).
Conclusions: The endoscopic approach might be considered as a useful option for patients with a large bladder diverticulum who are at risk for major or laparoscopic procedure.

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Published
2019-10-02
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Section
Original Papers - Prostate
Keywords:
Bladder diverticula, BPH, Urinary retention, HoLEP, TURP
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How to Cite
Pacella, M., Testino, N., Mantica, G., Valcalda, M., Malinaric, R., & Terrone, C. (2019). Transurethral endoscopic approach for large bladder diverticula: Evaluation of a large series. Archivio Italiano Di Urologia E Andrologia, 91(3). https://doi.org/10.4081/aiua.2019.3.174

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