Incidentally Found Meckel’s Diverticulum Used in the Creation of an Orthotopic Neobladder
A 62-year-old patient presented with gross total painless hematuria
and was diagnosed with muscle invasive transitional cell
carcinoma of urinary bladder.
We planned to perform a radical cystoprostatectomy
with formation of an orthotopic neobladder.
No major post-operative complications occurred.
After removal of the transurethral catheter, the patient voided with good flow.
Before removing suprapubic cystostomy tube, cystogram was
done which showed bladder, bladder neck and urethra similar in
appearance to the native one.
At 12-months of followup the neobladder functioned well without residual volume in the
neobladder with occasional nocturnal incontinence.
In review of literature, we found a single case report of using
a Meckel’s diverticulum for creation of neobladder in which
they found short mesoileum.
Meckel’s diverticulum is the most common congenital
malformation of the gastrointestinal tract.
It is an embryologic rest of the omphalomesenteric duct, which normally obliterates
in the seventh week of gestation. However, it is formed when
the intestinal end of the duct remains.
Meckel’s diverticulum is normally diagnosed due to a complication,
such as a gastrointestinal bleeding in 25 to 50% of the cases or an infection
in about 20% of the cases.
Obstruction, diverticulitis and intussusception are
also commonly seen. Symptoms may be due to inflammation and
ulceration in a Meckel’s with ectopic gastric or pancreatic tissue.
However, older patients are unlikely to have such findings.
Urol Androl Open J. 2019; 3(1): 7-9. doi: 10.17140/UAOJ-3-118