Davide Perri, Jean-Baptiste Roche, Bogdan Petrut, Giorgio Bozzini
{"title":"膀胱憩室治疗-保守和手术结果:来自EAU泌尿外科的叙述回顾。","authors":"Davide Perri, Jean-Baptiste Roche, Bogdan Petrut, Giorgio Bozzini","doi":"10.1097/MOU.0000000000001307","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Standardized treatment of bladder diverticula is not defined. The majority of evidence comes from single-centre case series and high-quality studies are lacking.</p><p><strong>Recent findings: </strong>Surgery is the preferred option to treat a symptomatic bladder diverticulum. Robot-assisted surgery has progressively replaced open approach, either with an extravesical or transvesical or transdiverticular technique, with favourable outcomes. Endoscopic treatment may represent a valid alternative mainly in old and frail patients. In case of intradiverticular tumour, some concerns arise on the optimal management between transurethral resection, partial and radical cystectomy. Pathological evaluation may underestimate the oncological status given the lack of muscular layer in the diverticular wall.</p><p><strong>Summary: </strong>Surgical diverticulectomy is considered the reference option for symptomatic diverticula. Robotics should be the preferred approach whenever available. Whatever the technique used (extravesical, transvesical, transdiverticular), good outcomes have been reported. Alternatively, endoscopic incision of diverticular neck and fulguration of the mucosa may be considered for selected patients. The relationship between bladder diverticula and bladder cancer is unclear and the choice between transurethral resection, partial or radical cystectomy should be based on multiple factors, starting from tumour stage and grade. However, evidence comes mainly from limited, heterogeneous case-series. Further studies are needed to properly assess the management of these patients.</p>","PeriodicalId":11093,"journal":{"name":"Current Opinion in Urology","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Bladder diverticula management - conservative and surgical outcomes: a narrative review from EAU endourology.\",\"authors\":\"Davide Perri, Jean-Baptiste Roche, Bogdan Petrut, Giorgio Bozzini\",\"doi\":\"10.1097/MOU.0000000000001307\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose of review: </strong>Standardized treatment of bladder diverticula is not defined. The majority of evidence comes from single-centre case series and high-quality studies are lacking.</p><p><strong>Recent findings: </strong>Surgery is the preferred option to treat a symptomatic bladder diverticulum. Robot-assisted surgery has progressively replaced open approach, either with an extravesical or transvesical or transdiverticular technique, with favourable outcomes. Endoscopic treatment may represent a valid alternative mainly in old and frail patients. In case of intradiverticular tumour, some concerns arise on the optimal management between transurethral resection, partial and radical cystectomy. Pathological evaluation may underestimate the oncological status given the lack of muscular layer in the diverticular wall.</p><p><strong>Summary: </strong>Surgical diverticulectomy is considered the reference option for symptomatic diverticula. Robotics should be the preferred approach whenever available. Whatever the technique used (extravesical, transvesical, transdiverticular), good outcomes have been reported. Alternatively, endoscopic incision of diverticular neck and fulguration of the mucosa may be considered for selected patients. The relationship between bladder diverticula and bladder cancer is unclear and the choice between transurethral resection, partial or radical cystectomy should be based on multiple factors, starting from tumour stage and grade. However, evidence comes mainly from limited, heterogeneous case-series. Further studies are needed to properly assess the management of these patients.</p>\",\"PeriodicalId\":11093,\"journal\":{\"name\":\"Current Opinion in Urology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-06-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Opinion in Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MOU.0000000000001307\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MOU.0000000000001307","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Bladder diverticula management - conservative and surgical outcomes: a narrative review from EAU endourology.
Purpose of review: Standardized treatment of bladder diverticula is not defined. The majority of evidence comes from single-centre case series and high-quality studies are lacking.
Recent findings: Surgery is the preferred option to treat a symptomatic bladder diverticulum. Robot-assisted surgery has progressively replaced open approach, either with an extravesical or transvesical or transdiverticular technique, with favourable outcomes. Endoscopic treatment may represent a valid alternative mainly in old and frail patients. In case of intradiverticular tumour, some concerns arise on the optimal management between transurethral resection, partial and radical cystectomy. Pathological evaluation may underestimate the oncological status given the lack of muscular layer in the diverticular wall.
Summary: Surgical diverticulectomy is considered the reference option for symptomatic diverticula. Robotics should be the preferred approach whenever available. Whatever the technique used (extravesical, transvesical, transdiverticular), good outcomes have been reported. Alternatively, endoscopic incision of diverticular neck and fulguration of the mucosa may be considered for selected patients. The relationship between bladder diverticula and bladder cancer is unclear and the choice between transurethral resection, partial or radical cystectomy should be based on multiple factors, starting from tumour stage and grade. However, evidence comes mainly from limited, heterogeneous case-series. Further studies are needed to properly assess the management of these patients.
期刊介绍:
Current Opinion in Urology delivers a broad-based perspective on the most recent and most exciting developments in urology from across the world. Published bimonthly and featuring ten key topics – including focuses on prostate cancer, bladder cancer and minimally invasive urology – the journal’s renowned team of guest editors ensure a balanced, expert assessment of the recently published literature in each respective field with insightful editorials and on-the-mark invited reviews.