canis - Articles
Bladder: diverticulum
Synonym(s): Vesicourachal diverticulum
Introduction
- Vestigial outpouching of bladder wall at urachal attachment, may be incidental surgical or radiographic finding.
- Signs: dysuria, hematuria, asymptomatic.
- Diagnosis: positive contrast cystography (without distending the bladder).
- Treatment: may resolve with medical treatment of concurrent urinary tract infection. May additionally require surgical excision of the affected area: diverticula may be difficult to identify in the deflated bladder at surgery.
- Prognosis: predisposes to chronic urinary tract infection and urolithiasis.
Presenting signs
- Dysuria.
- Hematuria.
- Asymptomatic (most diverticulae drain well with bladder emptying).
Pathogenesis
Etiology
- Urachus allows communication between urinary bladder and allantoic sac in fetus.
- At birth, urachus is non-functional and all urine flows through urethra in normal animals.
- There are 2 clinical syndromes:
- Congenital macroscopic vesicourethral diverticula may persist.
- Commonly remain clinically undetected until lower urinary tract infection develops.
Specific
- Concurrent urinary tract infection Cystitis and/or cystic calculi.
Pathophysiology
- Vestigial outpouching of bladder wall at urachal attachment (cranioventral pole of bladder).
- Diverticulum can lead to the failure to void all urine from bladder → development of urinary tract infection → scarring of bladder wall → increased risk of urinary tract infection.
Timecourse
- Months to years.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Scheepens E T F & L'Eplattenier H (2005) Acquired urinary bladder diverticulum in a dog. JSAP 46 (2), 578-581 PubMed.
- Lulich J P, Osbourne C A & Johnston G R (1989) Non-surgical correction of infection-induced struvite uroliths and a vesicourachal diverticulum in an immature dog. JSAP 30 (11), 613-617 VetMedResource.
- Wilson J W, Klausner J S, Stevens J B & Osbourne C A (1979) Canine vesicourachal diverticula. Vet Surg 8 (3), 63-67 Wiley Online Library.