Urachal Anomalies: A Longitudinal Study of Urachal Remnants in Children and Adults

Abstract

Urachal anomalies present and progress differently in pediatric and adult populations. Adults are at high risk for urachal cancer but children usually incur lower morbidity. Urachal lesions noted early in childhood should be excised to prevent problems in adulthood.

31 The initial experience of robotic-assisted laparoscopic partial cystectomy in urachal diseases

“…Adult patients with urachal anomalies should undergo an abdominal CT scan because of the high risk of malignancy of up to 25%. Ashley et al reported the increased risk of malignancy of a cystic urachal mass with increasing age [9]. In their study, 20% of patients with urachal cancer presented with metastatic disease.…”

“…agnosis [9]. Herein, we report our initial experience of 4 cases of RLPC performed on urachal diseases and evaluate the perioperative and pathologic results.…”

“…Sometimes this regression may be incomplete and the urachal remnant may persist into adulthood. Various urachal abnormalities, such as urachal sinus, urachal cyst, vesicourachal diverticulum, and patent urachus, may lead to abdominal pain, umbilical drainage, or urachal cancer [9][10][11]. The incidence of urachal anomalies is very low.…”

Umbilical-Urachus Sinus A variant of Patent Urachus Presentation With Management in Adults- A single Center Experience

“…In adults with persistant urachus 66% had hematuria or pain and 90% underwent excision. Surgical treatment in children consisted of simple excision, whereas over 50% of adults required partial or radical cystectomy because of malignancy [4] . A recent report showed that children are more likely to have an infected urachal cyst, while adults are more likely to have an infected urachal sinus [5] .…”

Intermittent ‘bulge’ in the umbilical cord

“…If urachal remnants are not removed in childhood and they are observed, exposure to chronic urinary stasis, infection and inflammation in the remnant may predispose the patient to potentially lethal malignancy. 10 The relative frequency of these lesions in six case series of 184 children with urachal anomalies is shown in Table 1. The precise incidence of an urachal remnant herniating into the umbilical cord (Figure 3b) is not described in the literature.…”