Table of ContentsView AllTable of ContentsStructureTypesComplicationsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Structure
Types
Complications
Diagnosis
Treatment
There are four types of urachal remnants, most of which don’t cause any symptoms. Although very rare, some urachal remnants progress to an aggressive type ofbladder cancercalled urachal cancer. To avoid the risk of complications, many adults choose to undergo surgery to remove the urachal remnant, a procedure called urachal resection.
This article explains the different types of urachal remnants along with how they are diagnosed and treated. It also covers the likelihood of a urachal remnant progressing to urachal cancer.
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What Is the Cause of Urachus?
As a fetus grows during pregnancy, there are many structures that change in order to accommodate the needs of the fetus to receive nutrition and to eliminate waste. One of these is the urachus, which is a tube that connects thebladderand the umbilicus.
Urine drains out through the urachus while the fetus is growing. This channel starts to close up around the 12th week of gestation. What’s left after it closes is a small cord that’s called the median umbilical ligament.
Types of Urachal Remnants
There are four main types of urachal abnormalities:
Urachal Remnant Complications
Most people with urachal remnants do not experience symptoms. Many only learn they have a urachal remnant when a complication develops.
Infection
The most frequent urachal remnant complication is infection, in which case one might experience:
Urachal remnant infections are commonly misdiagnosed as an umbilical hernia, appendicitis, or another type of infection, especially when the presence of the urachal remnant is unknown.
Urachal Cancer
Urachal remnants can develop a type of aggressive bladder cancer called urachal cancer. Urachal cancer is exceedingly rare, representing less than 1% of all bladder cancers and less than .01% of all cancers in adults.
Most people who are diagnosed with urachal cancer are between the ages of 46 to 71. The risk of urachal cancer is slightly higher in males.
The most common symptom of urachal cancer is blood in urine; about 73% of people with urachal cancer develop this symptom.Other possible symptoms of urachal cancer include:
How a Urachal Remnant Is Diagnosed
Most of the time, a urachal remnant is diagnosed in children. It’s possible, though, for a urachal abnormality to persist into adulthood without being diagnosed.
Urachal remnants might not cause any symptoms. However, there are some signs or symptoms that can prompt a physician to order tests to find out what the cause might be. This can include fluid draining from the umbilicus (navel), abdominal pain, a mass in the abdomen, or aurinary tract infection.
A urachal remnant is often found in children between the ages of two and four years. It’s estimated that about 1% of children are born with a urachal remnant. In some cases, a urachal abnormality that doesn’t cause any symptoms might only be found “incidentally.” It is discovered when there are tests done to look for another disease or condition.
Some of the tests that are done to diagnose a urachal remnant include:
How a Urachal Remnant Is Treated
When a urachal remnant is discovered, healthcare providers typically recommend surgical removal (resection) of the urachal remnant to prevent complications.
A urachal remnant that presents with infection is treated withantibioticsprior to surgical resection. After the abnormality is removed, there is no risk of it developing urachal carcinoma.
Urachal cancer is treated with surgical removal of the urachal remnant, and, depending on how advanced the cancer is, chemotherapy.
The type of surgery and associated treatment for the abnormality will depend on the type of urachal remnant, if there are any signs and symptoms or associated conditions, and the age of the patient.
For children, the preferred type of surgery is usuallylaparoscopicas opposed to open surgery.This is because the laparoscopic approach may leave less scarring since it is done through the use of a few small incisions.After the surgery, there may be a hospital stay of a few days.
Recent studies are also showing that laparoscopic surgery might be used successfully in adults as well to remove a urachal remnant.Once recovered from surgery, there isn’t usually a need for follow-up care.
Summary
A urachal remnant is a rare congenital disorder (a condition that’s present at birth) that may go undiagnosed unless there are symptoms. Symptoms can be nonspecific such as abdominal pain or urinary tract infection.
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. For those who have a concern about scarring on the abdomen, laparoscopic surgery may be an option.
12 Sources
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