{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T17:49:57Z","timestamp":1787766597573,"version":"build-2784847793"},"reference-count":34,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Laparoscopic and robotic bladder diverticulectomy is a successful option to correct bladder diverticula (BD). Nevertheless, the identification of BD could be a tricky step, due to the presence of pneumoperitoneum compressing the bladder. This occurrence could be particularly evident for the posterior or postero-lateral location of BDs. We present a novel technique to overcome this concern based on a rigid guidewire previously endoscopically placed and coiled inside BD, to ensure it expands and remains stable during the dissection. The technique was used in cases of diverticulectomy concomitant to other prostatic procedures. Methods: This is a multicentric series of laparoscopic and robotic diverticulectomy performed with this original technique in 34 patients. The procedure was concomitant to other prostatic intervention in most of the cases: TURP or bladder neck incision (16); radical prostatectomy (three); Millin adenomectomy (four cases). Surgical procedure: The first step of the procedure endoscopic, consisting of the retrograde insertion of a stiff guidewire inside the BD via cystoscopy; the guidewire is pushed in until it coils inside the diverticulum, and then enlarged to make it visible transperitoneally. The guidewire stretches the diverticulum and guides the dissection up to identify its neck. The primary endpoint is to address the feasibility of the technique by considering the operative time (OT, min) and the complication rate. Results: The median size of the BDs was 5.1 cm. The location of the BD was postero-lateral or posterior in all except one case. Bladder diverticulectomy was laparoscopically performed in 25 and robotically assisted in nine cases. Median OT was 179 min (DS 42). The post-operative course was uneventful for all except two patients with symptomatic urinary tract infections. Conclusions: The use of a stiff guidewire coiling and expanding the BD is a simple and useful trick to aid BD\u2019s identification and dissection; it aids diverticulectomy and is also concomitant to other prostatic procedures.<\/jats:p>","DOI":"10.3390\/jcm14061899","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:55:44Z","timestamp":1741755344000},"page":"1899","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Minimally Invasive Guidewire-Aided Bladder Diverticulectomy with or Without Other Prostatic Intervention: Step by Step Description of the Procedure"],"prefix":"10.3390","volume":"14","author":[{"given":"Bernardo","family":"Rocco","sequence":"first","affiliation":[{"name":"Unit of Urology, ASST Santi Paolo and Carlo, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Sighinolfi","sequence":"additional","affiliation":[{"name":"Unit of Urology, ASST Santi Paolo and Carlo, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"De Marzo","sequence":"additional","affiliation":[{"name":"Department of Urology, Regional Health Care and Social Agency Civil Hospitals of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Assumma","sequence":"additional","affiliation":[{"name":"Unit of Urology, ASST Santi Paolo and Carlo, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Sarchi","sequence":"additional","affiliation":[{"name":"Unit of Urology, ASST Santi Paolo and Carlo, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Panio","sequence":"additional","affiliation":[{"name":"Unit of Urology, ASST Santi Paolo and Carlo, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Calcagnile","sequence":"additional","affiliation":[{"name":"Unit of Urology, ASST Santi Paolo and Carlo, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Bozzini","sequence":"additional","affiliation":[{"name":"Department of Urology, ASST Lariana, 22100 Como, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0260-4601","authenticated-orcid":false,"given":"Riccardo","family":"Bertolo","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Verona, 37129 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinella","family":"Finocchiaro","sequence":"additional","affiliation":[{"name":"Department of Urology, ARNAS Garibaldi Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1720-1541","authenticated-orcid":false,"given":"Hakan G\u00f6rkem","family":"Kaz\u0131c\u0131","sequence":"additional","affiliation":[{"name":"Ayd\u0131n State Hospital Urology Clinic, Ayd\u0131n 09100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1934-1988","authenticated-orcid":false,"given":"Aryan","family":"Pathak","sequence":"additional","affiliation":[{"name":"Department of Urology, AdventHealth Global Robotics Institute, Kissimmee, FL 34747, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcio Covas","family":"Moschovas","sequence":"additional","affiliation":[{"name":"Department of Urology, AdventHealth Global Robotics Institute, Kissimmee, FL 34747, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vipul","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Urology, AdventHealth Global Robotics Institute, Kissimmee, FL 34747, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Falsaperla","sequence":"additional","affiliation":[{"name":"Department of Urology, ARNAS Garibaldi Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"ref_1","first-page":"505","article-title":"Bladder Diverticula: Etiology, Diagnosis, and Management","volume":"30","author":"Dmochowski","year":"2003","journal-title":"Urol. 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