UOTW #56

This patient is a 67 year old male who presents with lower abdominal pain associated with urinary frequency.  What finding here places the patient at increased risk of cystitis?



Answer: Bladder Diverticulum

This bladder ultrasound demonstrates a clear outpouching from the bladder, appears to communicate with the main bladder.  Color doppler demonstrates a small amount of urinary flow from the main bladder into the diverticulum.

  • Bladder Diverticula have a bimodal age distribution, peaking at age 10 and 60.
  • In the elderly cohort of patients who present with bladder diverticula, chronic urine outlet obstruction is the most common cause.1
  • Although often asymptomatic, these diverticula are associated with an increased risk of UTIs as well as bladder neoplasm due to chronic infection and stasis.2,3
  • When evaluating any organ with ultrasound, it is important to evaluate the entire 3D structure by fanning your 2D ultrasound beam all the way through.  If you fail to do this, you may miss important findings.
  1. A. J. Wein, L. R. Kavoussi, and A. C. Novick, Campbell-Walsh, Urology 9th Edition, W.B. Saunders, 2006.
  2. Melekos MD, Asbach HW, Barbalias GA. Vesical diverticula: etiology, diagnosis, tumorigenesis, and treatment. Analysis of 74 cases. Urology. 30(5):453-7. 1987. [pubmed]
  3. Mićić S, Ilić V. Incidence of neoplasm in vesical diverticula. The Journal of urology. 129(4):734-5. 1983. [pubmed]