Diverticulectomy

Bladder diverticulectomy is surgery to remove diverticula. These are pouches attached to your bladder by a piece of tissue called a neck.

They form when an obstruction stops urine from flowing. Pressure builds up in the bladder and pushes the lining through the bladder wall. Diverticulectomy is often done for several diverticula. It may be done if you have only one (called a diverticulum) that is large or preventing you from urinating.

How do I prepare for surgery?

You may need several tests before your surgery. A cystoscopy is a procedure to look inside your urethra and bladder with a cystoscope. A cystoscope is a small tube with a light and magnifying camera on the end. A sample of your urine may also be tested for signs of infection. An infection will need to be treated before you have a diverticulectomy. Ultrasound, MRI, or voiding cystourethrography pictures may be used to check the diverticula or your bladder. An obstruction (block) in your urethra found during one of these tests will need to be removed before you have a diverticulectomy.

Your surgeon will tell you how to prepare for surgery. Tell your provider about all the medicines you currently take. aspirin, and ibuprofen several days before your procedure. You will be told which medicines to take or not take on the day of surgery. You may be told not to eat or drink anything after midnight on the day of your surgery.

What will happen during surgery?

You will be given general anaesthesia to keep you asleep and pain-free during surgery. A Foley catheter will be guided into your bladder through your urethra. The catheter is used to empty urine from your bladder during surgery. Later in the surgery, it is used to fill the bladder with liquid. Stents may be placed in your ureters to help protect them from injury during surgery. A stent is a soft tube placed inside the ureter to keep it open. Your surgeon will tell you how long the stents need to stay in place. They may need to stay in for 2 weeks.

You may have open surgery or laparoscopic surgery. For open surgery, you will have 1 longer incision in your abdomen. Your surgeon will do this surgery only through this incision. Laparoscopic means your surgeon makes small incisions near the diverticula. He or she will guide a laparoscope into one of the incisions. This is a tube with a camera on the end. Your surgeon will guide tools into the other incisions.

Your surgeon will cut the neck of the diverticulum from the bladder. He or she will then remove the diverticulum. It may be sent to a lab to be tested for cancer. Your surgeon will close up the cut this makes in the bladder. The bladder will be filled with liquid to check for leaks and then drained. The surgery incisions on the outside of your body will be closed and covered with a bandage. A suprapubic catheter may also be left in place after surgery. This is a tube that enters the skin through the lower abdomen and goes into the bladder.

What should I expect after surgery?

The Foley catheter, and possibly the suprapubic catheter, will still be in place after surgery. These may stay in place for up to a week to help drain urine from your bladder. Your bladder may be irrigated (washed out) continuously for the first day or two after surgery.

Healthcare providers will help you walk safely for a short time after surgery. When you walk on the same day after surgery, you help prevent blood clots.

Risks

You may bleed more than expected during surgery. You may also develop an infection. Your ureter or bowel may be injured. You may develop a fistula, urinary tract infection (UTI), or an abscess (pocket of pus). You may also leak urine.

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