Robot-Assisted Bladder Diverticulectomy with Concurrent Management of Bladder Outlet Obstruction

Introduction: Robot-assisted bladder diverticulectomy (RABD) through a technique for easier identification of diverticulum along with concomitant management of bladder outlet obstruction (BOO) utilizing a combination of transurethral prostatectomy (TUR-P) and photoselective vaporization of prostate (PVP) is presented. Materials and Methods: Between 2008 and 2015, 9 patients underwent RABD with concurrent treatment of BOO. Diverticula were identified by a technique of catheterizing the diverticulum and the bladder simultaneously and individually. Results: Mean patient age was 62 +/- 9.8 and prostate volume was 70 +/- 26 ml. Mean time for endourological procedure was 77 +/- 35, mean console and total operative times were 108 +/- 38 and 186 +/- 56 min, respectively. Mean estimated blood loss was 71 +/- 37 ml. All diverticula were excised and BOO treated successfully. Bladder irrigation was not necessary in any patient. Mean hospitalization and catheter removal time was 5 +/- 3 and 8 +/- 3 days, respectively. No complications were observed. Conclusions: BOO is the main cause of acquired bladder diverticula and is largely due to benign prostatic hyperplasia. Concomitant performance of TUR-P and PVP along with RABD is feasible and safe. Individual catheterization of the diverticulum and bladder facilitates the identification of diverticulum even in the presence of multiple diverticula. (C) 2016 S. Karger AG, Basel