Urinary Bladder Diverticulum and Its Association With Malignancy: An Anatomical Study On Cadavers
Urinary Bladder Diverticulum and Its Association With Malignancy: An Anatomical Study On Cadavers
Urinary Bladder Diverticulum and Its Association With Malignancy: An Anatomical Study On Cadavers
ORIGINAL PAPER
Abstract
Present work was directed to study the prevalence and anatomical basis of diverticulum formation and its association with malignancy
inside the urinary bladder on cadavers. Urinary bladder diverticulum and its complications including malignancy has been reported by
different authors based on their study on radiological findings and endoscopy. Present study was undertaken on cadavers to meet the
aforementioned objectives. Thirty properly embalmed cadavers (19 males and 11 females) of different ages were dissected. Sagittal
section of pelvis was studied. Urinary bladder was incised to expose the interior and it was examined for the presence of diverticulum
(including number and location). Detailed history of the cause of death of cadavers with diverticulum was studied to determine how many
of them suffered from urinary bladder diverticular carcinoma. 23.4% cadavers (31.6% males and 9.1% females) showed presence of
urinary bladder diverticulum. The location of the diverticulum in all the cadavers was on superior and lateral side of the ureteric opening on
the posterior surface of the urinary bladder. Diverticulum of one male cadaver aged 74 years was complicated by malignancy. Our study
observed greater prevalence of diverticulum formation as compared to previous reports. In the present work, 14.3% diverticulum of the
urinary bladder showed malignant change, which is more than earlier reports in the literature. Urinary bladder diverticulum should neither
be neglected nor ignored. Appropriate early treatment (including the cause) of the diverticulum should be undertaken to avoid
complications like malignancy which will finally ensure longevity.
Keywords: cadaver, anatomy, urinary bladder, diverticulum, malignancy.
Figure 1 – Median view of the sagittal section of Figure 2 – Lateral view of the sagittal section of female
female pelvis showing diverticulum of the urinary pelvis showing diverticulum of the urinary bladder.
bladder. PB: Pubic bone; U: Urethra; V: Vagina; LM: PB: Pubic bone; S: Sacrum; UB: Urinary bladder; D:
Labia majora; R: Rectum; AC: Anal canal; UT: Diverticulum; U: Ureter.
Uterus; S: Sacrum; UB: Urinary bladder; D: Diverti-
culum; U: Ureter.
Table 1 – Details of the cadavers showing diverticulum formation in the urinary bladder
No. of Surface of urinary Diverticulum site in relation Presence of malignant
SN. Sex Age [years]
diverticulum bladder affected to the ureteric opening changes in the diverticulum
1. Male 50 1 No
2. Male 29 2 No
3. Female 70 1 No
4. Male 74 1 Posterior Above and outer side Yes
5. Male 66 1 No
6. Male 56 1 No
7. Male 61 1 No
In six out of thirty (16.7%) specimens, only one can be explained as follows. Majorities of cases diagno-
diverticulum was observed whereas one specimen sed as urinary bladder diverticulum are actually pseudo-
showed two diverticula in the urinary bladder (Table 1). diverticulum, which is difficult to distinguish through
All the seven specimens showed diverticulum formation endoscopy and radiological imaging techniques. They
in the posterior surface of the urinary bladder (Table 1). are composed of only mucosa and serosa, which is
The location of the diverticulum in all the seven formed in areas lacking muscle fibers.
cadavers was above and on the outer side of the ureteric Diverticulum of the urinary bladder is far more
opening (Table 1). History of one male cadaver aged common in males than females (ratio of 9:1) [6, 7].
74 years with one diverticulum formed on the upper and According to Russell RCG et al. [1], 95% of cases, the
lateral side of the ureteric opening on the posterior patient of bladder diverticula is a male over 50 years of
surface confirmed death by transitional cell carcinoma age. Our observation showed greater prevalence of
of the urinary bladder diverticulum (Table 1). diverticulum formation (31.6% in males and 9% in
females) as compared to aforementioned reports by
Discussion different authors. Its prevalence is more in men as
In our study, 23.4% of cadavers showed presence of compared to women, which is multifactorial. One
diverticulum in the urinary bladder. The high prevalence important factor contributing to diversity between both
Urinary bladder diverticulum and its association with malignancy: an anatomical study on cadavers 545
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Corresponding author
Prakash, Associate Professor, MD, Department of Anatomy, Vydehi Institute of Medical Sciences and Research
Centre, Whitefield, Bangalore, 560066 Karnataka, India; Phone +919480229670, +918028413838, Fax
+918028412956, +918028416199, e-mail: prakashrinku@rediffmail.com, prakash_sinha2005@yahoo.com