Bladder, ureter & renal pelvis

Other nonneoplastic


Last author update: 1 July 2011
Last staff update: 23 November 2020

Copyright: 2003-2023,, Inc.

PubMed Search: Bladder diverticula

Alcides Chaux, M.D.
Page views in 2022: 3,125
Page views in 2023 to date: 2,894
Cite this page: Chaux A. Diverticula. website. Accessed September 28th, 2023.
Definition / general
  • Outpouchings of urothelial mucosa through bladder muscular wall
  • Most diverticula are solitary lesions located in lateral walls of bladder
  • Congenital cases are due to bladder outlet obstruction or failure of muscle development (eMedicine: Surgery for Pediatric Bladder Anomalies [Accessed 11 July 2018])
  • Acquired cases are more common and usually due to prostatic enlargement causing muscular hypertrophy and focal mucosal herniation without muscularis propria in areas of weakness, often near ureteral orifices, bladder dome or urethral orifice
Clinical features
  • Most bladder diverticula are small and asymptomatic
  • When symptomatic, usually associated with infections and stones (due to urine stasis), urinary retention or perforation
  • Some cases are associated with additional GU anomalies (urethral strictures, neurogenic bladder, duplicated collecting system) or hereditable syndromes (Ehlers-Danlos, others)
  • Malignancy occurs in 1 - 10% of bladder diverticula
  • Tumors are often large because location is hidden
  • All variants of urothelial carcinoma have been reported in bladder diverticula, with a relatively higher frequency of unusual subtypes when compared to the general population
Case reports
  • Varies by patient - nonoperative treatment, surgical bladder outlet reduction or removal of the diverticulum
Gross description
  • Narrow necks, round / ovoid pouch from 1 - 18 cm (average 5.0 cm)
Gross images

Images hosted on other servers:

Image with case history

Microscopic (histologic) description
Nonneoplastic findings
  • Wall consists of fibrous tissue with no / scant muscularis propria
  • Common findings include inflammation, granulation tissue formation, erosion, cystitis cystica et glandularis, nonkeratinizing squamous metaplasia, reactive urothelial atypia

Neoplastic findings
  • Most neoplastic lesions that arise in bladder diverticula are urothelial carcinomas, mainly noninvasive papillary (high / low grade) or invasive
Back to top
Image 01 Image 02