Congenital Patent Urachus

Nix, Jeff; Menville, John G.; Albert, Matthew; Wendt, Donna

doi:10.1016/s0022-5347(17)66268-2

Cited by 106 publications

(40 citation statements)

References 37 publications

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“…With the development of the fetus, the urachal lumen progressively disappears, but there remains a small fibromuscular cord connecting the dome of the bladder to the umbilicus, referred to as the median umbilical ligament. There are three distinct layers, an outer smooth muscle layer, an intermediate submucosal connective tissue layer and an inner luminal layer (6). The cells of these three layers, particularly the epithelial cells, may give rise to urachal carcinoma (3).…”

Section: Discussionmentioning

confidence: 99%

Urachal carcinoma: Report of two cases and review of the literature

Quan

Pan

Jin

et al. 2016

Molecular and Clinical Oncology

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Abstract. Urachal carcinoma is a rare tumor that most commonly occurs in ovaries and less often in the adnexal region and urinary system. We herein present two cases of urachal carcinoma: One case was a 32-year-old male patient who presented with painless hematuria with blood clots for 1 month, whereas the other case was a 50-year-old woman who presented with gross hematuria with mild dysuria, urgency and frequent urination for 1 year. Following surgical resection, the two patients were diagnosed with urachal adenocarcinoma (mixed type) and urachal mucinous adenocarcinoma, respectively, based on the histopathological examination. A review of previously published cases and relevant literature is also presented. The aim of the present study was to help understand this disease better, in order to reduce the rate of clinical and pathological misdiagnosis. IntroductionUrachal carcinoma is a rare non-urothelial carcinoma, accounting for 0.01% of all malignancies and for 0.17-0.34% of all bladder tumors (1,2). Urachal carcinoma is more common among men, and the majority of the patients are aged >50 years (3). Although hematuria is the most common symptom, the disease is usually advanced when this symptom appears (4). As urachal carcinoma frequently invades the bladder at the dome or elsewhere along its midline, which is not easily detected during the early stages, it is often discovered late (5). Furthermore, there is currently no effective treatment for urachal carcinoma, leading to a poor prognosis. We herein report the cases of two patients with urachal carcinoma and urachal mucinous carcinoma. The relevant literature was also reviewed in order to help improve the diagnosis and treatment of this rare disease. Case reportsCase 1. The patient was a 32-year-old man who noted painless hematuria with blood clots for 1 month. There were no obvious precipitating or alleviating factors. On physical examination, there were no positive physical findings and the patient experienced no other discomfort. The results of the laboratory and imaging examinations (hemogram, urinalysis, prothrombin time, activated partial thromboplastin time, liver and kidney function tests and chest X-ray) were normal. However, urinary tract ultrasonography revealed an abnormal mixed signal at the bottom of the bladder. On further cystoscopy, only a small blood clot was detected. However, computed tomography (CT) revealed a circular hypodense mass located at the top and anterior part of the bladder, sized ~44x43 mm, without enlarged lymph nodes or other sign of metastatic disease (Fig. 1A).Following the doctors' recommendation, the patient consented to radical resection of the urachal tumor and partial cystectomy in August, 2015. We found that the lower part of the tumor was connected to the anterior wall of the bladder, whereas the upper part of the tumor was connected with the umbilical region. The tumor was sized ~7x8 cm. On gross pathological examination, the resected specimen was grey-yellow and gray-red, with a diameter of 6 cm. A small area co...

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Section: Discussionmentioning

confidence: 99%

Urachal carcinoma: Report of two cases and review of the literature

Quan

Pan

Jin

et al. 2016

Molecular and Clinical Oncology

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“…4 Congenital patent urachus is a rare anomaly occurring in only 3 of more than 1 000 000 admissions to a large pediatric center. 5,6 Patent urachus may present with local cord enlargement, edema, 7 delayed sloughing 8 or with periumbilical discharge. 5 This condition should be differentiated from that of omphalitis, umbilical granuloma, patent omphalomesenteric duct, infected umbilical vessel or external urachal sinus (Figure 3c).…”

Section: Discussionmentioning

confidence: 99%

Intermittent ‘bulge’ in the umbilical cord

et al. 2010

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“…The most accepted treatment for congenital patent urachus is the excision of the urachal tract, including the parietal peritoneum, from the umbilicus to the bladder. Partial resections of patent urachus may recur up to 30% [14]. Several authors perform a partial colpectomy, including the dome of the bladder to prevent malignant degeneration.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic management of urachal remnants in women affected of pelvic pain

Gilabert‐Estellés

Gilabert-Aguilar

2009

Gynecol Surg

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Symptomatic urachal cysts are very infrequently encountered in women affected of pelvic pain and uterine myomas. We report on two female patients aged 40 and 49 years, who underwent complete transperitoneal laparoscopic excision of urachal cysts at our unit. The first patient suffered from infertility and presented a uterine myoma, which was treated with laparoscopic myomectomy. The second case referred was menorrhagia and chronic pelvic pain, and she was treated with a total laparoscopic hysterectomy with complete excision of urachal cyst. All two operations had no serious immediate complications and minimal blood loss. Cysts were located at the lower third of the urachus, and no communication was detected between the cyst and the bladder. The bladder apex was reinforced using suturing in both cases, and a postoperative cystoscopy confirmed the integrity of the bladder wall. Patients were discharged uneventfully on the second postoperative day. In conclusion, complete excision of urachal remnants in women affected of pelvic pain is advisable in order to treat the symptoms and can be safely performed by a laparoscopic approach.

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Congenital Patent Urachus

Cited by 106 publications

References 37 publications

Urachal carcinoma: Report of two cases and review of the literature

Urachal carcinoma: Report of two cases and review of the literature

Intermittent ‘bulge’ in the umbilical cord

Laparoscopic management of urachal remnants in women affected of pelvic pain

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