Urology Care Foundation - What is a Bladder Diverticulum?
Centro de recursos Patient Magazine Podcast Donate
  2. Urology A-Z

Bladder Diverticulum

Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.

What is a Bladder Diverticulum?

A bladder diverticulum is a pouch in the bladder wall that a person may either be born with ("congenital") or get later ("acquired").

A congenital bladder diverticulum forms when some of the bladder lining pokes through a weak part in the bladder wall. A congenital diverticulum is most often found when you are still a child, and often there is often only one pouch. The diverticulum doesn’t always cause problems, but sometimes it can trap urine, get infected or lead to other issues. People with this condition might need special care or treatment if problems develop.

Diagram of a Bladder with Two Diverticula

Enlarge

Acquired bladder diverticula are similar to congenital bladder diverticula, but they develop later in life, rather than being present at birth. These pouches or bulges form in the wall of the bladder over time, often due to pressure in the bladder or other problems that affect the bladder’s function.

Some common causes of acquired bladder diverticula include:

  • Blockages in the urinary system (like an enlarged prostate or kidney stones) that make it harder for urine to flow out of the bladder.
  • Chronic urinary retention, where the bladder doesn’t empty completely, causing pressure that leads to these pouches forming.
  • Nerve problems that affect bladder control.

Acquired bladder diverticula can sometimes lead to infections, urinary problems or other complications, so people who have them may need medical treatment to prevent or manage issues.

How Does the Bladder Usually Work?

The bladder is a balloon-shaped organ that stores urine, which is made in the kidneys. It is held in place by pelvic muscles in the lower part of your belly. When it isn't full, the bladder is relaxed. Muscles in the bladder wall allow it to expand as it fills with urine. Nerve signals in your brain let you know that your bladder is getting full. Then you feel the need to go to the bathroom. The brain tells the bladder muscles to squeeze (or "contract"). This forces the urine out of your body through your urethra. 

Diagram of the Male and Female Urinary Tracts

Enlarge

Symptoms

The symptoms of bladder diverticula can vary, and some people may not have any symptoms at all. But, when symptoms do happen, they can include:

  1. Frequent Urination. You may feel like you need to go to the bathroom a lot, even if you don’t have much urine to pass.
  1. Pain or Discomfort. You might feel pain or discomfort in the lower part of your belly or bladder area, especially when you try to pass urine.
  1. Trouble Emptying the Bladder. Sometimes, the bladder might not empty fully, so you may feel like you still need to go after using the bathroom.
  1. Urinary Tract Infections (UTIs). Bladder diverticula can trap urine, which can lead to infections. This may cause symptoms like:
  • Burning or pain when passing urine
  • Cloudy or strong-smelling urine
  • Feeling very thirsty or tired
  1. Blood in the Urine. You might notice blood in your urine, which can appear pink, red or brown.
  1. Urinary Retention. This is when you can’t fully empty your bladder, and it leads to a feeling of pressure or fullness in the lower belly.
  1. Bladder Stones. Sometimes, stones can form in the diverticulum. If this happens, you might feel sharp pain or have trouble passing urine.

If you have any of these symptoms, it is of great value to see a doctor for a proper diagnosis and treatment.

Diagnosis

To diagnose bladder diverticula, your health care team may do a few different tests to see if there are pouches or bulges in the bladder and check how well the bladder is working.

Here are the common tests:

  1. Ultrasound: This test uses sound waves to take pictures of the bladder. It can show if there are any unusual pouches or bulges.
  2. CT scan (Computed Tomography): This is like a special x-ray that creates detailed pictures of the bladder and other organs. It can help doctors find any diverticula and check if there are any problems like infections.
  3. Cystoscopy: In this test, a doctor uses a small camera on a tube (called a cystoscope) to look inside the bladder. This can help the doctor see if there are any diverticula or other issues in the bladder.
  4. X-ray with contrast: Sometimes, a special liquid (called contrast) is used during an x-ray to make the bladder show up better on the pictures. This can help doctors see the diverticula more clearly.

These tests help the health care team understand if you have bladder diverticula and decide the best treatment if needed.

Treatment

The treatment for bladder diverticula depends on whether it's causing problems. Some people don’t need treatment if the diverticula aren’t causing any issues, but if there are problems, here are the treatments your health care team might use:

  1. Antibiotics. If a diverticulum gets infected, doctors will usually give antibiotics to help fight the infection and make it go away.
  1. Catheterization. If the bladder isn’t emptying properly because of the diverticulum, doctors may suggest using a catheter. This is a small tube that helps drain urine from the bladder. It helps reduce pressure and can prevent infections.
  1. Surgery. Sometimes, surgery may be needed if the diverticulum is causing big problems, like frequent infections, bladder stones or blockages. Surgery could involve:
  • Removing the diverticulum: The doctor may take out the pouch and fix the bladder.
  • Fixing blockages: If something else is causing the diverticulum, like a blockage, surgery can fix that.
  1. Treating Other Health Problems. If there are other issues causing the diverticula, like an enlarged prostate or nerve problems, doctors may treat those conditions to help improve bladder function.
  1. Lifestyle Changes. Sometimes, doctors will suggest drinking more water, using the bathroom regularly and not holding urine for too long. These changes can help the bladder work better and reduce problems.

The treatment depends on how bad the diverticula are and what symptoms someone has. Your health care team will help decide the best way to treat it.

After Treatment

Treatment often works and may help your symptoms. In some cases, after the cause of the diverticulum (such as a block in the bladder) is fixed, you won’t need to be treated further. Your health care team may want to check the diverticulum with a cystoscope through the urethra once in a while.

After surgery, you will need to have a catheter to drain your bladder for one or two weeks.

Some rare risks of diverticulum surgery are:

  • damage to the intestines or ureters (the tubes that carry urine from the kidneys)
  • urine leaking from the bladder after surgery
  • infection

Some patients will need to have the diverticulum removed with open surgery later. If your bladder doesn't work well, you may need to help drain it with a catheter.

Updated November 2024. 

Explore Further

Urology Care Podcast
Urology Care Podcast

Listen to The Urology Care Podcast, the Urology Care Foundation’s official podcast.

UrologyHealth extra
UrologyHealth extra®

Read the latest issue of UrologyHealth extra®, the Urology Care Foundation's patient-focused magazine.