Laparoscopic diverticulocystoplasty

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Pejman Shadpour, Masoud Etemadian

Abstract

Secondary diverticula initially serve as a pop-off mechanism in high-pressure voiding. Large diverticula, however, have been implicated in bladder-neck and ureteral obstruction and frequently demand definitive treatment, which, so far, has usually meant excision. We present this first report on using the diverticulum for laparoscopic urothelialized bladder augmentation as a novel procedure. We performed laparoscopic freehand sutured diverticulocystoplasty in 3 adult male patients suffering from low-capacity, low-compliance bladders accompanied by hydroureteronephrosis. All 3 patients had a dominant large diverticulum with very poor drainage by voiding and catheterization. The technique is described in detail. Patients were followed for upper tract changes and bladder anatomy by cystogram, sonography antegrade pyelography (per case), and laboratory studies. The procedures lasted 114-152 minutes. Patients were discharged uneventfully on postoperative day 3. At the 9-month follow-up, mean functional bladder capacity had increased by 266% (range, 195-351), and mean maximum detrusor pressure had dropped by 190% (range, 167-234). At 15-32 months, upper tract dilation has improved in all 3 patients. All patients remain on intermittent...Continue Reading

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Citations

Jan 16, 2013·JSLS : Journal of the Society of Laparoendoscopic Surgeons·Manickam RamalingamMizar Ganapathy Pai

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