[Malformations of the urachus; two cases of congenital cysts of the urachus].
Explore the source record for details and available documents.
Cysts↗
SEARCH · Search PubMed
Results for “Urachus”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Urachus cancer--a rare malignant form of urachus abnormality].
Explore the source record for details and available documents.
Adenocarcinoma, Mucinous↗
Sonomorphology and involution of the normal urachus in asymptomatic newborns.
BACKGROUND: The number of reports on the sonomorphology of the urachus or urachal remnants in neonates and the pattern of involution is limited. OBJECTIVE: To determine whether a sonographically visible urachus in the first months of life is a pathologic condition and whether postnatal involution can be demonstrated by ultrasound. MATERIALS AND METHODS: A total of 102 asymptomatic infants (premature and term newborns) were examined with a high-resolution 7.5-MHz linear transducer between 0 and 60 days of age. In 70 infants, a second examination followed 3-5 months later. RESULTS: In all infants, the urachus could be identified on the first examination. Different morphological types were differentiated. There was no difference between premature and term newborns in the morphology of the urachus. Spontaneous involution of the urachus was observed in all infants receiving a second examination, and they most often showed a fusiform urachal remnant at the apex of the bladder. CONCLUSION: Involution of the urachus is not complete at birth and can be followed up sonographically in the first months of life. This knowledge should prompt a new strategy in young infants with a discharging umbilicus or even an infected urachus. Instead of early surgery, a conservative approach under sonographic control seems reasonable, because there is a chance of spontaneous involution and any abnormal development can be detected by ultrasound.
Female↗
Ovine fetal urachus--physiological and hormonal control of its contractile activity.
We have investigated whether the ovine fetal urachus near term has the potential to regulate the passage of urine from the bladder into the allantoic cavity. Experiments were performed primarily on longitudinal urachal muscle. In Krebs bicarbonate buffer (pH 7.4 bubbled with 95% O2-5% CO2 at 37 degrees C) the urachus spontaneously developed a prolonged elevated resting tension (RT, 1.1-1.5 g). Intra-abdominal urachus showed a greater development of tension than extra-abdominal urachus, which was associated with the amount of smooth muscle observed in histological specimens. Isoproterenol (1 microM) produced a significant reversible reduction in RT (1.36 +/- 0.15 to 0.67 +/- 0.08 g, P less than 0.01, mean +/- SE). Replacement of normal-O2 buffer (PO2 420.4 +/- 19.5 mmHg) with a low-O2 buffer (PO2 101.3 +/- 4.7 mmHg), or very low-O2 buffer (PO2 38.2 +/- 2.2 mmHg) while maintaining PCO2 and pH constant, produced a reduction in RT (from 1.35 +/- 0.21 to 0.52 +/- 0.13 g and from 1.20 +/- 0.17 to 0.46 +/- 0.04 g, respectively; both P less than 0.01). This effect was reversed when high PO2 was reinstated. Circular muscle showed a similar response when PO2 was reduced. The urachus showed a significant increase in RT (0.74 +/- 0.08 to 1.71 +/- 0.28 g, P less than 0.01) when prostaglandin F2 alpha (PGF2 alpha; 10 microM) was added to the low-O2 buffer. These results demonstrate that the urachus can develop spontaneous contractile activity and responds to alterations in O2, a beta-agonist, and PGF2 alpha.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Laparoscopic excision of the urachus.
Embryologically, the urachus represents the obliterated alantois in the form of a fibrous cord extending from the dome of the bladder to the umbilicus. Incomplete obliteration can result in the formation of an umbilical sinus, fistula, cyst, or abscess in the infraumbilical area. The traditional treatment of a residual urachus is surgical resection of the entire tract from the dome of the bladder to the umbilicus through a lower midline incision. We report the case of a 14-year-old girl who presented with an abscess below the umbilicus. After initial drainage, she developed a sinus that communicated with the navel. Surgical resection of the underlying urachus was carried out laparoscopically. The peritoneum was incised at the umbilicus, and the whole tract along with the skin sinus was excised using diathermy scissors. The lower end was ligated and the specimen retrieved. The patient was discharged the following day. One week later, her wounds had healed. Histology confirmed an epithelial-lined urachus. We believe that laparoscopic excision of a patent urachus is feasible and safe. This technique gives the surgeon good access to the area and has a cosmetically better result.
Abdominal Abscess↗
Nonoperative management of a patent urachus.
Patent urachus accounts for 10% to 15% of all reported urachal abnormalities in the literature. Treatment in the past has relied on immediate surgery. Conservative therapy with bladder catheter drainage, resulting in spontaneous closure, has not been described. We report a case of patent urachus in a 6-day-old infant who presented with urine drainage from the umbilicus. Radiographic studies confirmed a patent urachus. One week of urethral catheterization resulted in spontaneous closure of the patent urachus. This case suggests that initial treatment should consist of urethral catheterization for 1 to 2 weeks, followed by repeat voiding cystourethrogram. If the patent urachus still persists, one should proceed to surgical correction.
Congenital Abnormalities↗
Diagnosis and management of a patent urachus in a white rhinoceros calf (Ceratotherium simum simum).
A 10-day-old female southern white rhinoceros calf (Ceratotherium simum simum) was diagnosed with a patent urachus after urine was observed dribbling from the umbilicus. After being separated from its mother, the animal was sedated with i.m. butorphanol and anesthetized with isoflurane in oxygen for surgical correction of the patent urachus. Mild postoperative complications involved seroma formation and partial skin incision dehiscence, which necessitated three follow-up immobilizations for reevaluation and treatment of the surgical site. Histopathology did not reveal an infectious etiology as the cause for the complications or for the patent urachus. The etiology of the patent urachus in this animal remains undetermined. This report represents the first documented case of a patent urachus in a white rhinoceros.
Animals↗
[Patent urachus in childhood].
Over the past 20 years (1971-1990) 12 infants and children have been treated surgically for a partial or totally patent urachus in the Surgical Unit of the University Children's Hospital of Pécs, Hungary. This anomaly is of special interest to pediatric surgeons, general surgeons, urologists, paediatricians. After a short survey of the embryology and pathology of the urachus, the authors analysed their material. All but one of their patients underwent surgery without serious complications. In a 6-year-old girl the urachus recanalized following shrinkage of the bladder. The authors emphasize the need of radical removal of the partial or totally patent urachus, however, this extirpation should be carried out in a froid state, frequently following incision and drainage of the suppurating urachus.
Child↗
Uroperitoneum attributable to ruptured urachus in a yearling bull.
Ruptured urachus was found to result in uroperitoneum in a yearling Beefmaster bull. The uroperitoneum was initially believed to be attributable to ruptured bladder secondary to urolithiasis; however, catheter decompression of the bladder through an ischiatic urethrotomy did not resolve the uroperitoneum. The persistent urachus was diagnosed and removed through caudal right flank laparotomy with the bull standing. The urachus was attached to the umbilicus, communicated with the lumen of the bladder, and had a mucosal lining. Ruptured urachus is an unusual cause of uroperitoneum, but can cause clinical signs identical to those of ruptured bladder. Persistent urachus is a congenital abnormality in many species, but may be hereditary in Beefmaster cattle. In addition, the bull in this report developed hyperkalemia, which is considered an unusual finding in cattle with uroperitoneum.
Animals↗
Treatment of patent urachus associated with a congenital imperforate urethra in a calf.
Patent urachus is a common condition in calves which is frequently associated with omphalitis. A membranous urethral diaphragm prevented closure of the urachus in a female calf. The patent urachus was complicated by an ascending infection of the intraabdominal umbilical remnants. Following surgical removal of the urachus and umbilical vessels along with transection of the membranous diaphragm the calf experienced an uncomplicated recovery. This case stresses the importance of assuring urethral patency when managing a case of patent urachus.
Abnormalities, Multiple↗
Adenocarcinoma of the urachus and bladder expresses a unique colonic epithelial epitope: an immunohistochemical study.
PURPOSE: Primary adenocarcinoma of the bladder is a rare neoplasm whose histogenesis is poorly understood. Current data support the concept that adenocarcinoma of the bladder and urachus evolves from zones of intestinal metaplasia that become dysplastic and invasive. To address this hypothesis further we determined the immunoreactivity of benign and malignant epithelial tissue from the bladder and urachus with a monoclonal antibody that is reactive with colonic epithelium to evaluate the presence of a common reactive epitope. MATERIALS AND METHODS: The monoclonal antibody 7E12H12 (IgM isotype), developed against a colonic epithelial protein, was used in an immunoperoxidase assay to survey formalin fixed, paraffin embedded archival tissue specimens. A total of 26 specimens obtained by endoscopic biopsy or extirpative surgery, including benign and malignant bladder and urachal epithelial abnormalities, was chosen for retrospective evaluation. RESULTS: All adenocarcinoma reacted positively regardless of the histological variant, differentiation, or bladder or urachal origin. In contrast, transitional cell and squamous cell carcinomas were nonreactive. Also, the pattern of reactivity in tissues that contained benign epithelial proliferations suggested a stepwise transition with no reactivity in normal urothelium or Brunn's epithelial nests, rare staining of cystitis cystica, and uniformly positive reactivity in cystitis glandularis and frank colonic intestinal metaplasia of the bladder and urachus. CONCLUSIONS: The shared, aberrant phenotypic expression of a unique colonic epitope in benign epithelial metaplasia, and adenocarcinoma of the bladder and urachus suggests a common underlying pathway toward adenocarcinoma in cystic and urachal adenocarcinoma. The implications for diagnostic pathology are discussed.
Adenocarcinoma↗
Persistent patent urachus with allantoic cyst: a case report.
Patent urachus results when there is a persistence of an allantois remnant which normally undergoes atresia during embryological development. It can lead to an abdominal wall defect similar in appearance on ultrasound to an omphalocele. A 34-year-old primigravida presented at 19 weeks' gestation for evaluation of a cystic mass arising at the umbilical cord insertion. The initial impression of the referring physician was an omphalocele. The mass arose from the abdominal wall and the umbilical cord inserted into the membranous covering of the mass, which appeared to be fluid-filled and separate from but contiguous with the urinary bladder. Serial sonography followed the progression of the abdominal wall mass. At term, the patient underwent primary Cesarean section with delivery of a 4494-g male infant. The infant underwent repair and closure of the patent urachus and plastic reconstruction of the abdominal wall. When the urachus remains patent, it can lead to a urinary fistula which mimics the ultrasound appearance of an omphalocele. However, patent urachus is associated with a much lower rate of abnormalities than omphalocele, yielding a better fetal prognosis.
Adult↗
[Papillary urothelial carcinoma of the urachus].
OBJECTIVE: Persistence of a patent urachus is a relatively rare occurrence; however; the persistence of urachal remnants is common. The pathologic lesions of the urachus include benign and malignant neoplasms. The majority of malignant urachal neoplasms are adenocarcinomas. METHODS AND RESULTS: We report a case of papillary urothelial carcinoma of urachus in a 73-year-old woman. The patient was treated with complete surgical extirpation and partial cystectomy. CONCLUSION: The recognition of urachal remnants as vestigial structures and pathologic lesions of the urachus is important.
Aged↗
Patent urachus with subsequent joint infection in a free-living Grevy's zebra foal.
A free-living, female Grevy's zebra (Equus grevyi) foal was found lethargic, lame, with swollen joints, pyrexia, and urine dripping from the umbilicus. It died 2 days later despite intensive care. Gross examination revealed patent urachus and suppurative arthritis. Swabs were taken from the joints, the patent urachus, and urine for bacteriology. The dominant isolate was Escherichia coli. The joint infection was probably secondary to septicemia, resulting from the patent urachus. To our knowledge, this is the first report of neonatal patent urachus in a wild equid.
Animals↗
[Transitional cell carcinoma of urachus: a case report].
We report a case of transitional cell carcinoma of urachus in a 72-year-old man. At follow up cystoscopy for past history of bladder cancer, we found a papillary tumor in the right orifice that came out to the bladder cavity intermittently. Although there was no cancerous lesion on the surface of the bladder mucosa, a submucosal eminence at the dome of bladder was observed. Sagittal magnetic resonance imaging (MRI) revealed an extravesical tumor (2 cm) at the position of urachus. Under the diagnosis of right ureteral cancer and urachal cancer, we performed right distal ureterectomy, ureteral reimplantation and total resection of urachus. Pathological examination revealed transitional cell carcinoma in the urachus and right ureter. The urachal cavity was isolated completely from the bladder cavity. Tumor infiltrated to the muscularis of the bladder dome from the urachal cavity, but there was no cancerous lesion on the surface of the bladder mucosa. Therefore, our diagnosis was urachal transitional cell carcinoma and right ureteral carcinoma.
Aged↗
[Patent urachus associated with abdominal abscess: report of a case].
A case of the patent urachus associated with abdominal abscess was reported. A 44-year-old woman was consulted to our clinic with the complaints of bladder irritability and discharge from the navel on October 27, 1987. A fist-sized tumor around the umbilicus was pointed out and the cystography from the umbilicus demonstrated that the contrast medium reached to the urinary bladder. The cystoscopy showed the protruded lesion on the dome of the bladder. The pre-operative diagnosis was patent urachus. She received resection of the urachus on November 11, 1987. The pathological finding was pyogenic granuloma of the urachus due to chronic inflammation.
Abdominal Muscles↗
A case of a closed partial cloacal septation defect with a patent urachus.
A boy with a closed partial cloacal septation defect with a patent urachus is reported. He had an intact abdominal wall, a patent urachus, a colovesical fistula, intact genitalia and urethra, imperforate anus, and a lipomyelocystocoele. Patients with similar constellation of findings have been reported as cloacal exstrophy variants. What distinguishes this case from the other reported variants is the intact abdominal wall with the patent urachus, the small and normally formed phallus and urethra, and the presence of a lipomyelocystocoele. We discuss the possible embryologic mechanism responsible for this boy's findings and possible relationship with the cloacal exstrophy spectrum. We also discuss new terminology for the epispadias-exstrophy spectrum. Furthermore this case reminds us that there is considerable variability within the epispadias-exstrophy spectrum.
Abnormalities, Multiple↗
Remnants of urachus in infants and children--the problems of diagnosis and treatment.
A total of 17 cases of remnants of urachus were examined between 1981 and 1989, including 2 cases of patent urachus, 5 of urachal cyst, 9 of urachal sinus, and 1 of urachal diverticulum. A long urachal sinus was considered to be caused by the self-destruction of a cyst. While patent urachus was diagnosed in neonates with urine discharge from the umbilicus, cysts or sinuses accompanied by infection were more often found in older children. Imaging of the burrows was diagnostic in 8 out of 11 cases, ultrasound examination in 9 out of 12, and CT examination in all of 3 cases. Since this condition is frequently accompanied by malformations of the urinary system, attention must be paid to locating the accompanying anomalies. Although primary extraction was performed in 13 cases, the primary treatment of cases with highly infected cysts should be drainage, followed by secondary extraction. Furthermore, caution must be exercised to avoid hemorrhage in cases with dilation of the umbilical artery.
Child↗