Can anyone report a successful BPH procedure (invasive, non-invasive) with Bladder diverticulum?

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With a bladder diverticulum, it seems to me that unless a prostate is well over 30 grams, incontinence issues may arise. I have bladder diverticulum. I go back to Uro in early January to discuss options after being on alpha blockers for now (Rapaflo is only one that seems to work for me decently).

Obviously, I will want (not looking for to) Urodynamic testing.

Basically, can anyone report out there having successful BPH procedure, minimally invasive to more invasive while leaving the bladder diverticulum alone? Again, my main concern would be incontinence. Retro does not concern me - having no bladder control and peeing myself constantly DOES concern me. Thank you!

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9 Replies

  • Posted

    I don't see how diverticulum can cause incontinence, unless they are right at the bladder neck. Hank

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    • Posted

      Less bladder pressure. I've read some literature on this. Basically, if a smaller prostate, one does a TURP or equally invasive procedure with Bladder Div, incontinence shows up more. I'm not entirely sure where my Div is (Uros where I live basically stink), but have a question sheet filled out for next appointment. My prostate appears to be on the small side so I think it's possible my Bladder Div is actually the primary cause of BOO. Thanks for your reply!

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    • Posted

      Lvscott

      If you have a small prostate that may not be the problem. It may be inside your bladder at the ureter entrance.

      And why would you have a invasive procedure like a Turp ( That may cause you more problem then what you have now ) if you don't need one and don't know what is causing it. . Please find out what is causing the problem before you do anything

      Best of luck.......Ken

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  • Posted

    Good evening.

    I had to look this up because I never heard of it. It is cause by many thing and you can even be born with it. Do you plan on having the bladder repaired or are you just going to leave it alone.

    Sometime unless you have problem you can leave it alone.

    First you need to find out why this is happening. It can be congenital or acquired. Congenital is from birth. Acquired it can be from urethra scarring, a stricture, a blockage of the ureter and of course the prostate

    Do you know how big your procedure is. Once you find out what is causing this you will have to go from there and talk it over with your doctor. If it is your prostate I feel if you want something to relieve the pressure off of your bladder the Urolift would be the easiest. They can clip it open and in 2 to 4 weeks you should be good to go. No side effects and you may be able to get off the Rapaflo

    Good luck and please let us know what is going on. This is the first time I have heard of this......Ken

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    • Posted

      Bladder Diverticulum is rather common actually in men with BPH. It's missed a lot on Cystoscopy (Mine wasn't missed). Cystrogram CT finds them more precisely. I've been studying Uro Lift and Rezum. Not wild about Rezum as it just blows tissue away. Uro Lift I find more interesting, but I see potential issues with that in terms of prostate growing more over time, potential clips popping off, etc, etc.

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  • Posted

    Hi, I did not have bladder diverticulum and I know very little about it, but how have you concluded if the prostate is well over 30 grams there is a chance of incontinence? unless the surgeon damages the bladder neck valve so that it does not shut off properly or if it is already compromised and the surgeon damages the prostate lower valve, I had a very successful FLA approx 11 months ago, for my enlarged prostate median lobe but still have to pee too often because I waited too long before having FLA but am still hoping to retrain the bladder to hold urine longer, however in your case even if you get your blockage sorted out it may not be wise to purposely hold back the urine as that may increase the diverticulum problem so it may be a case of getting it unblocked wherever the blockage is and still having to pee a lot if the bladder has already been restricted too long like mine but keep in mind it may gradually recover , also try not to push your pee out as I presume that may increase your diverticulum problem, your situation will be much worse if you choose a surgical method and surgeon that causes you to end up with incontinence and that will depend on the reason for your blockage, I used Dr Karamanian in Houston Texas he may have some advice for you, he is always willing to help and very knowledgeable, its worth an email, you will find him on the internet, hope this helps despite my not having had bladder diverticulum.

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    • Posted

      Thanks;... Yes, I'm familiar with FLA and Dr. K in Houston. The 30G prostate I mentioned is from the data literature (I cover biotech public companies, so part of my job is to read a ton of research papers). TURP is an overused barbaric procedure, so I have no interest in that. GL PVP is basically a bit less invasive TURP. Button Plasma Turp interests me because it's a more precise cutting method with a ton less bleeding and uses Saline, so that eliminates TUR syndrome. Perhaps one of the most promising procedures coming up and is being used now is Aquablation.

      FLA seems interesting for sure. Both FLA and Aqua are not covered by insurance in any way. I believe FLA is 30k, and Aqua is an absurd 70k right now. I can afford either one, but want to do a lot more research into these things. Recently grabbed some self-Caths just in case.

      I do push a tad my pee out to empty correctly, but not too hard. My situation went from decently livable to depressing lately, all because I strained too hard taking a poop. I think that's when I believe I caused the Bladder Div, as I felt something strange in my bladder. I'll get all the tests done after the New Year to figure this out. Thanks for all the input!

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    • Posted

      Lyscott

      That is very good that you are aware of the procedures but Aquablation is just another way of doing a Turp. Just with water. And you are out before they do any mapping. Does not seam right. Because you have no say of anything that is done.

      With FLA Dr' K will show you what he is going to take out. Before you are put to sleep

      They still have a problem with trying to stop the bleeding. I talked with my doctor and he said that catheter balloon is not a good idea it can damage other thing in the area.

      Have a great night.......Ken

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  • Posted

    Hi LVScott

    I had a PAE (Prostate Artery Embolization ) in January 2018

    It has been very effective.I have good sex every 2nd day (if my woman is around) and pee properly.

    It was done by a radiologist without an anesthetic and was painless.

    I first had a cystoscopy by a uroligist - to look for possible causes of the BPH like cancer,kidney stones etc.

    Then I had an MRI / CAT Scan to map the blood vessels.

    I live in Durban in South Africa and the Dr is Gareth Bydawell

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