Abstract
Purpose
Bladder diverticula (BD) are usually asymptomatic, but may increase the risk of infections, stones, or malignancy, likely due to urinary stasis within the BD. We aim to characterize the risk of bladder cancer (BC) within diverticula.
Methods
Retrospective review was conducted of patients diagnosed with BD between 1994 and 2021 at a single institution. Cancer risk was characterized using descriptive statistics and multivariable logistic regression as appropriate.
Results
We identified 764 patients with mean age 68 years, the majority of whom were male (87%) and Caucasian (86%). Of this total, 13.3% (102/764) had a diagnosis of BC and 35.3% of this subset (36/102) had definitive cancer within the BD. Diverticulectomy or partial cystectomy was performed in 13.6% (104/764), 76% of whom were preoperatively presumed to have benign disease. Surgical patients were younger and had larger BD. Of the 79 patients who underwent diverticulectomy without preoperative suspicion for cancer, 5 were incidentally diagnosed with BC on final pathology. On multivariable logistic regression, male gender [odds ratio (OR) = 2.6, p = 0.03] and increasing age (OR = 1.02, p = 0.03) were independent risk factors for BC diagnosis. Indwelling catheter, recurrent urinary tract infections (UTIs), and bladder stones did not affect the risk of BC.
Conclusions
The majority of patients with BD are not managed with surgery. BC is identified in a small but considerable proportion of patients with BD, with an even lower rate of incidentally diagnosed cancer among those undergoing BD surgery. Male gender and increasing age increased the risk of BC diagnosis.
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Data availability
The raw/processed data required to reproduce the above findings cannot be shared at this time due to legal/ethical reasons.
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MED-F: protocol/project development, data collection or management, data analysis, and manuscript writing/editing. UAA: protocol/project development, data collection or management, manuscript editing. JPEA: data collection. MGS: data collection. PM: data collection. KWA: project development and manuscript editing.
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DeWitt-Foy, M.E., Anele, U.A., Accioly, J.P.E. et al. Cancer risk in bladder diverticula: a large institutional analysis of risk and management. Int Urol Nephrol 55, 541–546 (2023). https://doi.org/10.1007/s11255-022-03447-3
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DOI: https://doi.org/10.1007/s11255-022-03447-3