This video shows Trabeculation of the Urinary bladder with a Diverticulum.
Trabeculation of the bladder affects the amount of urine that your bladder can hold and the way that it's emptied. A trabeculated bladder is no longer able to expand when filled with urine and contract when emptied. This cycle can lead to urinary incontinence, infection, and kidney damage.
The normal bladder wall had a mean thickness of 2.76 mm when the bladder is almost empty and 1.55 mm when it is distended. There is a linear relationship between bladder fullness and bladder wall thickness; the upper limits are 3 and 5 mm for a full or empty bladder respectively.
The normal bladder capacity before you feel any sensation of urge is about 300 cc's (10 oz.). Normal voiding volumes are 210-300 cc's (7-10 oz.) with the first-morning voiding usually being the largest at 400-500 cc's.
The stretching of the bladder wall can increase the size of the bladder from about 2 inches to more than 6 inches long, depending on the amount of liquid. The typical human bladder reaches its capacity between 16 to 24 ounces of urine, but the urge to urinate comes when the bladder is about one-quarter full.
The symptoms of an enlarged bladder can be frustrating, but the condition on its own is not a grave health concern. Once an enlarged bladder has been developed, it is unlikely to return to its former state. However, the symptoms can be managed so that they cause less stress to the person affected.
Bladder outlet obstruction can arise from a number of conditions affecting the urethra and/or bladder outlet but is most commonly encountered in elderly men due to Prostate enlargement.
Obstruction can be caused by multiple etiologies but is most often seen from urethral strictures, mass lesions within the periurethral region, prostate enlargement, and congenital urethral valves.
The bladder can regenerate like nobody's business and now we know why. The bladder is a master at self-repair. When damaged by infection or injury, the organ can mend itself quickly, calling upon specialized cells in its lining to repair tissue and restore a barrier against harmful materials concentrated in the urine.
Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome.
Interstitial cystitis (IC) is a painful condition in which the bladder wall becomes irritated and inflamed. Chronic irritation can cause scarring and thickening of the bladder wall, making the bladder very stiff and unable to hold a normal amount of urine.
Radiographic features On radiographic evaluation, the bladder wall appears thickened and trabeculated. Urinary retention is noted with increased post-void residual on sonographic or voiding studies.
Diverticula are often an incidental finding on imaging.
A bladder diverticulum is a pouch in the bladder wall that a person may either be born with ("congenital") or get later ("acquired"). A congenital bladder diverticulum forms when some of the bladder linings poke through a weak part of the bladder wall. With acquired diverticula, many pouches often form.
Bladder diverticula occur as a result of focal herniations of the urothelium and submucosa and usually occurs in the setting of chronic elevation of intravesical pressure. Pelvic (Bladder) ultrasound shows a large outpouching of the bladder wall and mucosa projecting from the lumen of the bladder.
Acquired bladder diverticula (more than 1 diverticulum) are most often caused by a block in the bladder outlet (such as from a swollen prostate or scars in the urethra), the bladder not working well because of nerve injury, or, rarely, from prior bladder surgery.
Bladder diverticula are uncommon but not rare. In their pediatric genitourinary database of 5084 children, Blane and colleagues3 found a 1.7% incidence of bladder diverticulum. Bladder diverticula may be acquired or congenital. Acquired diverticula are usually multiple and associated with bladder trabeculation.
Rupture of a bladder diverticulum is a rare occurrence, and its diagnosis is difficult. An earlier diagnosis requires a high index of suspicion. MDCT cystography should be used as the first-line modality when evaluating for a suspected bladder rupture, even in patients with nontraumatic bladder rupture.
A change in bowel habits such as diarrhea or constipation may also be seen. Patients may also have urinary symptoms such as the increased need to urinate and urinary urgency.
Although small diverticula are usually asymptomatic, a large diverticulum may result in hematuria, urinary tract infection, acute abdomen due to its rupture, acute urinary retention, or neoplasm formation.
Bladder diverticula can be managed in several different ways, including conservative nonoperative management, surgical excision, and endoscopic management. Indications for treating bladder diverticula include urinary infection, stones, or malignancy.

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