Cured by Da Vinci Xi: meticulous dissection of an infected urachal cyst presenting with lower urinary tract symptoms in an adult

Abstract

An unusual finding in an adult patient with an infected urachal cyst, was treated surgically using the Da Vinci robot. A 26-year-old woman was admitted to our hospital with complaints of lower abdominal pain and burning sensation with urination. She was diagnosed with lower urinary tract infection, treatment did not help her symptoms and further evaluation of CT revealed complex enhancing mass superior to the urinary bladder. The differentials included inflammatory cause such as an abscess, neoplastic mass, urachal cyst, vitello intestinal fistula and urachal sinus. Da Vinchi robotic diagnostic laparoscopy was performed to obtain an accurate assessment and treatment. After cystoscopy followed by laparoscopic exploration of the abdominal and pelvic cavity further helped to narrow down a diagnosis of remnants of urachus. Pathology of the excised specimen showed inflammation without evidence of malignancy and confirmed Urachal cyst. The patient had an uneventful post-operative course.

The Efficacy Analysis of Laparoscopic Treatment of Pediatric Urachal Cysts

“…For the treatment of urachal cysts, especially in children younger than 1 year old, and particularly those under 6 months of age with small, asymptomatic urachal cysts, conservative management can be considered [23]. This typically involves regular observation and monitoring of the cyst's size and symptoms.…”

Robot-assisted excision of urachal cyst: case report in a child

“…Abnormalities in involution of the urachus may result in patent urachus, umbilical urachal sinus, vesico-urachal diverticulum, and urachal cyst [1]. In particular, a urachal cyst is reported to occur in 0.02% of live births but is symptomatic in just 0.00067% of the population [4]. An inadvertent rupture of a quiescent urachal remnant may, rarely, occur during a laparoscopic procedure, during port placement.…”