Laparoscopic Management of Patent Urachus in an Adult Man

Pust, Alexandra; Ovenbeck, Ralph; Erbersdobler, Andreas; Dieckmann, Klaus‐Peter

doi:10.1159/000106336

Cited by 10 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most cases documented have advocated laparoscopic radical excision of the patent urachus [6,7]. The authors have found two documented cases of perforation of a previously undiagnosed urachal remnant in an adult at laparoscopy in English language papers.…”

Section: Discussionmentioning

confidence: 99%

Conservative management of a urachal remnant perforation during laparoscopic ovarian cystectomy

et al. 2009

View full text Add to dashboard Cite

Complications associated with persistent urachal remnant disease have been well documented in neonates and more recently in adults. These include laparoscopic perforation. The case has previously been made for conservative management of small symptomatic urachal remnants in young infants and also for conservative management of iatrogenic cystotomies in the absence of overt sepsis using assisted bladder drainage and prophylactic antibiotics. However, to our knowledge, there has been no recent case of successful conservative management of laparoscopically perforated urachal remnant in an adult. This case describes the incidental perforation of a suspected urachal remnant in an adult female which resulted in an infected anterior abdominal wall collection. The patient was treated with assisted bladder drainage and intravenous antibiotics. Evidence of healing was demonstrated 4 weeks later using a cystogram.A 29-year-old female with no previous medical or surgical history presented with dysmennorrhoea and hirsutism. Ultrasound demonstrated a 6-cm cyst on her right ovary, with appearances suggestive of a dermoid. She was referred to secondary care for right-sided abdominal pain and admitted for laparascopic ovarian cystectomy. A 6-7-cm right-sided dermoid cyst was removed via the suprapubic port with copious washout. The procedure was otherwise uneventful.Post-operatively, she was unable to pass urine and required catheterisation. The next day, she developed a right-sided, erythematous and oedematous rash involving the right labia majora. This was initially thought to be an allergic chemical peritonitis from the washout fluid which was treated with chlorpheniramine and steroids. She then became pyrexial and was treated with co-amoxiclav for urinary tract infection and cellulitis. She experienced delayed return of voiding until day 5 post-operatively when she was discharged on oral antibiotics with some improvement in her rash.She then presented 2 days later with abdominal pain and distension with vomiting. Examination revealed a grossly distended abdomen with features of tense ascites and a persistent rash. A clear fluid exudate was noted at the umbilical port scar. Laboratory analysis was consistent with a sample of urine. She was recatheterised due to ongoing voiding difficulties.

show abstract

Section: Discussionmentioning

confidence: 99%

Conservative management of a urachal remnant perforation during laparoscopic ovarian cystectomy

et al. 2009

View full text Add to dashboard Cite

show abstract

“…After the infection has cleared, excision of the defect can then be performed. The urachal anomaly can be removed by open surgical, laparoscopic, or robotic‐assisted technique (Pust, Ovenbeck, Erbersdobler, & Dieckmann, 2007). Reports of successful laparoscopic removal of urachal anomalies have been cited in several professional medical journals (Allen et al, 2004; Peters, 2004).…”

Section: Managementmentioning

confidence: 99%

Enhancing nurse practitioner understanding of urachal anomalies

Severson

2011

Journal of the American Academy of Nurse Practitioners

View full text Add to dashboard Cite

Purpose: To provide nurse practitioners an understanding of urachal anomalies, their presentations, and treatment options. Data sources: Scientific literature, including articles that address the pathogenesis, presentation, complications, diagnosis, and treatment of acquired and congenital urachal anomalies. Conclusion: Urachal disorders occur in 1 of 5000 persons. Complications from these disorders are even rarer. Early recognition of these anomalies can reduce the incidence of more serious complications such as secondary infections, sepsis, abscess formation, recurrent cystitis, and neoplasms. Implications for practice: Nurse practitioners will encounter patients with stable and acute complications from urachal anomalies. Awareness of these anomalies can expedite diagnosis, treatment, and referral therefore improving patient outcomes.

show abstract

“…In 1999, a review 10 reports only 10 cases treated laparoscopically but, to our knowledge, these reports in adult in the last 10 years of literature are not frequent. At present (PubMed search), some authors report single adult cases [11][12][13][14][15][16] However, all these authors refer only about patients treated by laparoscopic technique and, after having focused on surgical technique, report on how it is feasible, safe, and effective, particularly with regard for hospital stay, morbidity, convalescence, cosmetics, and not least, the almost complete absence of relapse. None of these studies is comparative with the open technique, and thus, results in terms of effectiveness are at least questionable.…”

Section: Malignant Transformation Later In Lifementioning

confidence: 99%