What is urachal remnant surgery?
Urachal remnants (UR) represent a failure in the obliteration of the allantois, which connects the bladder to the umbilicus, at birth. Surgical management of UR in children is controversial. The traditional surgical approach involves a semicircular intraumbilical incision or a lower midline laparotomy.
Should urachal remnants be removed?
In many cases, the medical team may recommend surgery to remove the remnant because of the possibility of complications and because it is associated with a rare, but aggressive form of cancer. In most cases the anomaly can be removed and recovery is uneventful.
What causes Urachal fistula?
A urachal fistula is a congenital disorder caused by the persistence of the allantois (later, urachus), the structure that connects an embryo’s bladder to the yolk sac.
How long does Urachal cyst surgery take?
Mean operative time was 180 minutes (range 150 to 210) and average hospital stay was 2.75 days (range 1 to 4). Pathological evaluation confirmed a benign urachal remnant in each case. All patients resumed normal activity within 2 weeks.
How is a urachal cyst removed?
Treatment of urachal cysts is complete excision due to the risk of malignant transformation. Single-stage excisions result in significantly more complications and longer hospitalization, whereas the two-stage approach, i.e., an incision and drainage followed by a secondary excision, is usually complication free [4, 6].
What is a urachal mass?
Urachal cyst develops when urachus remains patent in between the closed umbilical and vesical endpoints. It usually occurs in the lower third, close to the urinary bladder. It remains usually asymptomatic and diagnosed incidentally. As with other urachal remnants, most common complication is infection [3].
What is a urachal tract?
The urachus is a remnant of a channel between the bladder and the umbilicus (belly button) where urine initially drains in the fetus during the 1st trimester of pregnancy.
What is urinary fistula?
A bladder fistula is when an opening forms between the bladder and some other organ or the skin. Most often the bladder opens to the bowel (“enterovesical fistula”) or the vagina (“vesicovaginal fistula”).
How is an umbilical fistula treated?
Once an umbilical-enteric fistula is diagnosed, the treatment of choice is radical surgical resection. The risk of malignant degeneration of the transitional epithelium of the inner urachal duct is unknown but probably small. The risk of recurrent symptoms is probably higher.
How many hours is laparoscopic surgery?
When laparoscopy is used to diagnose a condition, the procedure usually takes 30-60 minutes. It will take longer if the surgeon is treating a condition, depending on the type of surgery being carried out.
Is there a minimally invasive treatment for urachal remnant?
The standard of care for this disease is complete resection of all anomalous tissue including a bladder cuff to avoid recurrence. The traditional surgical approach includes large transverse or midline infraumbilical incision. Several reports have shown that minimally invasive technique could be successful in patients with urachal remnant.
How is the excision of an urachal cyst done?
The single-stage excision involves a primary excision of the infected urachal cyst and bladder cuff, whereas the two-stage procedure involves a primary incision and drainage, a delay to ensure that the infection has cleared, and then a later excision of the urachal remnant and bladder cuff. Go to: RESULTS
What kind of surgery is needed for urachal sinus?
The other four patients with urachal sinus underwent laparoscopic surgery with excision of the urachal remnant, from the umbilicus to the urinary bladder. All patients with urachal diverticulum underwent open excision of the diverticulum through a Pfannenstiel incision.
What should I do if I have urachal disorder?
If the urachal disorder presents with an infection, the infection is treated first. This requires antibiotics, possible admission for intravenous antibiotics, and occasional surgical drainage of any infected cyst or poorly draining cavity.