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Management of Urachal Remnants in Early Childhood

2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2008.03.105

1527-3792

Vincenzo Galati, Ben Donovan, Faridali Ramji, Jeffrey Campbell, Bradley P. Kropp, Dominic Frimberger,

Urological Disorders and Treatments

No AccessJournal of UrologyBladder1 Oct 2008Management of Urachal Remnants in Early Childhood Vincenzo Galati, Ben Donovan, Faridali Ramji, Jeffrey Campbell, Bradley P. Kropp, and Dominic Frimberger Vincenzo GalatiVincenzo Galati , Ben DonovanBen Donovan , Faridali RamjiFaridali Ramji , Jeffrey CampbellJeffrey Campbell , Bradley P. KroppBradley P. Kropp , and Dominic FrimbergerDominic Frimberger View All Author Informationhttps://doi.org/10.1016/j.juro.2008.03.105AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Generally, it is recommended that all urachal remnants be excised to avoid recurrent disease and possible malignant transformation later in life. However, spontaneous resolution with no need for further intervention has been reported. We reviewed the experience with urachal remnants at a single institution and evaluated which patients could be treated nonoperatively and which required surgical intervention. Materials and Methods: We reviewed the medical records and radiographic studies of all patients with urachal remnants from January 1999 to January 2007. Patients were analyzed according to initial presentation, imaging findings and treatment. Serial clinical examinations and radiographic imaging were used to follow patients. Results: An external urachal sinus was found in 9 patients (39.1%) and 1 was surgically excised. Of the 12 urachal cysts (52.2%) 9 ultimately required surgical excision, of which 6 were infected initially. A patent urachus was found in 2 patients, which resolved during an observation period. Radiographic imaging and/or physical examination diagnosed all remnants initially and confirmed complete resolution during followup. Eight of the 10 urachal remnants (80.0%) that resolved developed in patients younger than 6 months. Various accompanying urogenital anomalies were found in 8 patients (34.8%). Conclusions: A small urachal remnant, especially at birth, may be viewed as physiological. Urachal remnants in patients younger than 6 months are likely to resolve with nonoperative management. However, if symptoms persist or the urachal remnant fails to resolve after 6 months of age, it should be excised to prevent recurrent infections. References 1 : Urachal remnants: sonographic assessment. J Clin Ultrasound1996; 24: 339. Google Scholar 2 : Laparoscopic radical excision of urachal sinus. J Endourol2003; 7: 475. Google Scholar 3 : Malignant urachal lesions. J Urol1984; 131: 1. Link, Google Scholar 4 : Urachal anomalies: ultrasonography and management. J Pediatr Surg2003; 38: 1203. Google Scholar 5 : Congenital patent urachus and acquired variants. Diagnosis and treatment. Review of the literature and report of five cases. Acta Chir Scand1971; 137: 807. Google Scholar 6 : Ten years of experience with isolated urachal anomalies in children. J. Urol1997; 158: 1316. Link, Google Scholar 7 : Management of urachal anomalies in children and adults. Urology1993; 42: 426. Google Scholar 8 : Surgical implications of urachal remnants: presentation and management. J Pediatr Surg2003; 38: 798. Google Scholar 9 : Urachal anomalies in children: a single center experience. Yonsei Med J2006; 47: 782. Google Scholar 10 : Nonoperative management of a patent urachus. Urology2005; 66: 1320. Google Scholar 11 : Laparoscopic radical excision of urachal sinus. J Endourol2003; 17: 475. Google Scholar Departments of Urology and Radiology (BPK), University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByGleason J, Bowlin P, Bagli D, Lorenzo A, Hassouna T, Koyle M and Farhat W (2018) A Comprehensive Review of Pediatric Urachal Anomalies and Predictive Analysis for Adult Urachal AdenocarcinomaJournal of Urology, VOL. 193, NO. 2, (632-636), Online publication date: 1-Feb-2015.Copp H, Wong I, Krishnan C, Malhotra S and Kennedy W (2009) Clinical Presentation and Urachal Remnant Pathology: Implications for TreatmentJournal of Urology, VOL. 182, NO. 4S, (1921-1924), Online publication date: 1-Oct-2009. Volume 180Issue 4SOctober 2008Page: 1824-1827 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsurachusurination disordersabnormalitiesallantoisbladderMetricsAuthor Information Vincenzo Galati More articles by this author Ben Donovan More articles by this author Faridali Ramji More articles by this author Jeffrey Campbell More articles by this author Bradley P. Kropp Financial interest and/or other relationship with Cook Biotech. More articles by this author Dominic Frimberger More articles by this author Expand All Advertisement PDF DownloadLoading ...