Ota Kuniaki, Kamiyama Hirohiko, Shimizu Tomo, Ajiro Yoshiki, Nohara Shigeo, Shuno Yasutaka, Kobayashi Takashi, Ota Yoshiaki, Takahashi Toshifumi
Department of Obstetrics and Gynecology, Tokyo Rosai Hospital, Tokyo, Japan.
Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
BMC Womens Health. 2025 Jun 4;25(1):278. doi: 10.1186/s12905-025-03837-6.
Bladder diverticulum is a rare pelvic mass that arises from a defect between the detrusor muscle fibers. It does not often cause distinct symptoms and is most commonly detected accidentally in postmenopausal women as an ovarian cyst while investigating unrelated ailments. Therefore, preoperative diagnosis is difficult, and there are cases of intraoperative embarrassment in the absence of an ovarian cyst.
A 76-year-old woman who was diagnosed with an ovarian cyst using abdominal computed tomography (CT) at another institution was referred to our department for further evaluation. Magnetic resonance imaging (MRI) showed similar findings, and the radiologist diagnosed it as a serous ovarian cyst, for which laparoscopic surgery was planned. Laparoscopic findings however, did not reveal any evidence of the preoperatively diagnosed ovarian cyst in the pelvic cavity. Furthermore, due to swelling in the left retroperitoneal cavity, the area was further explored. A mass with serous content was identified and resected. During the procedure, the ureteral balloon catheter was exposed, revealing that the excised mass was a bladder diverticulum complicated by bladder injury. Subsequently, the bladder injury site was laparoscopically sutured and repaired. Four weeks post-surgery, urological imaging confirmed complete reconstruction of the bladder injury, and the indwelling ureteral balloon catheter was successfully removed.
We experienced a case of complete laparoscopic excision and bladder injury repair of a massive bladder diverticulum mimicking an ovarian cyst. Bladder diverticula, though rare, should be considered in the differential diagnosis of pelvic masses, particularly in post-menopausal women with equivocal preoperative diagnoses to avoid unnecessary surgical interventions.
Bladder diverticula should be considered in the differential diagnosis of pelvic masses, particularly in postmenopausal women, as they can mimic ovarian cysts.
膀胱憩室是一种罕见的盆腔肿物，由逼尿肌纤维间的缺损形成。它通常不会引起明显症状，最常见于绝经后女性在检查无关疾病时偶然被发现为卵巢囊肿。因此，术前诊断困难，并且存在在没有卵巢囊肿的情况下术中出现窘迫情况的病例。
一名76岁女性在另一机构通过腹部计算机断层扫描（CT）被诊断为卵巢囊肿，随后被转诊至我科进行进一步评估。磁共振成像（MRI）显示了类似的结果，放射科医生将其诊断为浆液性卵巢囊肿，并计划进行腹腔镜手术。然而，腹腔镜检查结果并未发现盆腔内有术前诊断的卵巢囊肿的任何迹象。此外，由于左腹膜后腔肿胀，对该区域进行了进一步探查。发现并切除了一个含有浆液的肿物。在手术过程中，输尿管球囊导管暴露，显示切除的肿物是一个合并膀胱损伤的膀胱憩室。随后，通过腹腔镜对膀胱损伤部位进行了缝合和修复。术后四周，泌尿外科影像学检查证实膀胱损伤已完全重建，留置的输尿管球囊导管成功拔除。
我们遇到了一例完全腹腔镜切除并修复膀胱损伤的巨大膀胱憩室病例，该憩室酷似卵巢囊肿。膀胱憩室虽然罕见，但在盆腔肿物的鉴别诊断中应予以考虑，特别是在术前诊断不明确的绝经后女性中，以避免不必要的手术干预。
在盆腔肿物的鉴别诊断中应考虑膀胱憩室，特别是在绝经后女性中，因为它们可能酷似卵巢囊肿。
