Laparoscopic vesical diverticulectomy

Purpose: We report our initial experience with 13 cases of laparoscopic vesical diverticulectomy done via an extravesical approach between November 2002 and October 2004. Patients and Methods: All patients were male, with a mean age of 53 years and a mean body mass index of 26.2 kg/m(2). A transperitoneal approach was preferred. The diverticulum was of the primary type in three patients and of the secondary type resulting from benign prostatic hyperplasia in seven patients and a long-standing urethral stricture in three patients. Results: The mean operative time was 265 minutes with a mean blood loss of < 100 mL and a mean postoperative hemoglobin decline of 1.1 g/dL. The urethral catheter was removed on day 7 postoperatively in the patients with a primary diverticulum, whereas it was left for 11 to 14 days in patients with secondary bladder diverticula. Postoperative complications occurred in only one patient with a primary diverticulum, taking the form of extravasation from the suture line in the control gravity-fill cystogram that was done routinely prior to urethral-catheter removal. Leakage resolved with urethral catheterization for 2 more weeks. The postoperative stay was 3 to 4 days. Conclusion: Laparoscopic diverticulectomy is technically feasible and safe and may represent an alternative to the standard open procedure.