Hutch diverticula are congenital bladder diverticula, seen at the vesicoureteric junction, in the absence of posterior urethral valves or neurogenic bladder. They are thought to result from a weakness in the detrusor muscle anterolateral to the ureteral orifice.
They occur almost exclusively in boys with an estimated prevalence of approximately 2% 3.
Urinary tract infection, incontinence, or urinary retention are the most common presentations.
Round or oval anechoic fluid collections arising from the base of the urinary bladder or around the ureteric orifice 1.
Treatment and prognosis
Incidentally detected diverticula usually do not require any therapy. If associated with reflux, recurrent infection, or obstruction, they should be resected. However, because of the risk of the development of carcinoma, some surgeons advocate prophylactic surgery in all cases. Hutch diverticula are prone to spontaneous rupture, as well as post-surgical recurrence.
History and etymology
Primary and secondary paraureteric diverticula were first described by American urologist John Hutch (-1972) in 1961 4.
- "bladder ears"
- these are transient outpouching normally seen in infants, and represent normal protrusions of urinary bladder into the inguinal rings
- lateral voiding cystourethrogram usually clarifies the diagnosis
- 1. Berrocal T, López-pereira P, Arjonilla A et-al. Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics. 22 (5): 1139-64. Radiographics (full text) - Pubmed citation
- 2. Bachiller burgos J, Varo solís C, Báez JM et-al. [Congenital bladder diverticulum and Ehlers-Danlos syndrome: an unusual association]. Actas Urol Esp. 2000;24 (8): 673-6. - Pubmed citation
- 3. Blane CE, Zerin JM, Bloom DA. Bladder diverticula in children. Radiology. 1994;190 (3): 695-7. Radiology (citation) - Pubmed citation
- 4. Hutch JA. Saccule formation at the ureterovesical junction in smooth walled bladders. (1961) The Journal of urology. 86: 390-9. Pubmed
- 5. Jain VK, Kumar S, Singh RK, Netam SS. Congenital Bladder Diverticula Detected on Imaging. (2016) The Journal of pediatrics. 170: 331. doi:10.1016/j.jpeds.2015.12.007 - Pubmed