RC ASAP is my recommendation. Diverticula have no muscle wall. So once it grows it is automatically PT3 and can reach nodes very easily. Or worse: PT4 with growth elsewhere.

This sounds like papillary. Very often you will also find CIS.

I regret not having an annual or semiannual cystoscopy after I was diagnosed with a diverticulum in 2018.

The urologist in NC at the time emphasized it was benign and congenital.

It turns out there is an increased risk for bladder cancer because of urine stasis in diverticula.

Now I am dealing with two TURBTs, PT3AN1M0, RC, DDMVAC and now nivolumab to hopefully eradicate low MRD so there is no recurrence.