Intradiverticular Bladder Tumors: Experience from a Tertiary Care Institute

Background: Intradiverticular bladder tumors (IDBTs) are rare urothelial malignancies arising within bladder diverticula and pose unique diagnostic and therapeutic challenges due to altered anatomy and absence of the muscularis propria. Materials and Methods: We retrospectively reviewed the institutional bladder cancer database for IDBTs managed between 2010 and 2024. Clinical presentation, imaging findings, cystoscopic features, histopathology, management strategies, and outcomes were analyzed. Results: All patients were male, with a median age of 70 years. Hematuria was the most common presenting symptom (80%). Tumors were predominantly high-grade urothelial carcinomas arising from lateral (40%), posterior wall (20%), or bladder base (20%) diverticula. Management included transurethral resection (60%), partial cystectomy with diverticulectomy (20%), and radical cystectomy (20%) based on the tumor extent and patient factors. At a median follow-up of 14 months, all patients remained disease-free. Conclusion: IDBTs are uncommon but clinically significant tumors that frequently exhibit aggressive behavior and staging uncertainty. Early recognition and individualized surgical management are critical for optimal outcomes.