Urinary bladder diverticulum

Case contributed by Dr Varun Babu

Presentation

Hesitancy, frequency.

Patient Data

Age: 55 years
Gender: Male
MRI

Prostate is enlarged, approximately 60 grams. Central gland hypertrophy with intravesical protrusion. Heterogeneous well defined T2 hyperintense nodules are seen in the central gland. Loss of normal T2 hyperintensity of the peripheral zone in mid gland more on the left side. A 11mm midline prostatic cyst seen.

Partially distended urinary bladder has catheter in situ. Prominent trabeculations with a small diverticular outpouching in right lateral wall. 

Case Discussion

Features of age related benign prostatic hyperplasia present. Two nodules in central gland show diffusion restriction, whilst bilateral peripheral zones show T2 hypointensity. This warrants spiking PIRADS category to 4 and suggesting a PSA correlation and a transrectal guided prostatic biopsy to rule out neoplasm. 

The urinary bladder outpouching could be a long standing sequel to bladder outlet obstruction. 
 

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