PMC6735193_01
Abdominal CT shows urachal remnant and bladder diverticulum. (a-d) The fibrous cord runs from the umbilicus to the dome of the bladder (arrow). (e) A large bladder diverticulum locates in the right lateral wall (arrow). (f) CT findings nine months after the operation revealing no recurrence of the diverticula.
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Computed tomography (CT) showed urachal remnant (urachal diverticulum at the dome of the bladder) and a large bladder diverticulum at the right lateral wall (Figures 1(a)-1(e)). Foley catheter was removed on the seventh postoperative day, and she was discharged home on the same day. For 18 months after the operation, she was able to void without residual urine, urinary tract infection ceased to develop, and had no recurrence of the diverticula (Figure 1(f)).
Cystoscopic examination showed a diverticulum neck at the right wall and urachal diverticulum at the dome of bladder. (a, b) The diverticular mucosa was redness, and (c) erosion.
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Cystoscopic examination showed a large diverticulum at the right wall, and diverticular mucosa was reddish and erosive (Figures 2(a) and 2(c)). Urachal diverticulum was small and without inflammation (Figure 2(b)).
(a) The placements of the trocar port.  : operator's and assistant's port;  : camera port. (b) The umbilicus and umbilical ligament viewed from the right working port. (c) Excision of the umbilical ligament just above the bladder dome. The bulging of the bladder diverticulum is identified just to the right side of the bladder dome (arrow). (d) After resection of the bladder diverticulum. The urachal diverticulum is identified just to the left of the resection site (arrow).
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We prepared the five working ports (Figure 3(a)). First, we inserted a camera into the right side working port of the umbilicus height and dissected the urachal ligament and adjacent tissues toward the bladder using the remaining right working port (Figure 3(b)). We could confirm the bulging of the bladder diverticulum just to the right side of the bladder dome (Figure 3(c)). The resection line was extended to the bladder dome, and the urachal diverticulum was also resected (Figure 3(d)).