Bladder Diverticulum : Clinical Presentation

Small bladder diverticula are frequently asymptomatic and discovered incidentally. Larger ones often empty poorly during micturition leading to urinary stasis which can result in non-specific lower urinary symptoms, hematuria or infection. Congenital bladder diverticula usually present with acute UTI but can also cause enuresis, pyelonephritis, acute retention, hematuria, abdominal pain, and abdominal mass. Urothelial carcinoma may develop in acquired diverticula in adults in <10% of cases. Congenital bladder diverticula are not associated with increased risk of malignancy.

The image shows urothelial lining of a bladder diverticulum. The umbrella cells have abundant oncocytic cytoplasm and show hobnailing.