Abstract
Purpose: Urachal sinus is presented with infections of the umbilicus mainly in adolescents; symptomatic urachal sinus is frequently excised. However, it is unknown whether asymptomatic urachal sinuses after infection require removal. The patients with urachal sinus were reviewed to investigate the necessity of removal.
Methods: A 5-year retrospective study revealed 15 patients with urachal sinuses. An ultrasound scan revealed urachal remnants, and cystography were mainly used to detect the patency of sinus to the urinary bladder.
Results: A total of 15 patients with urachal sinus consisted of 14 males and 1 female aged 5–31 (mean: 19.3) years. Lower abdominal pain, redness and swelling of the umbilicus were observed in all patients, and discharge of pus was noted in 12. The length of sinuses were 14–75 (mean: 30.7) mm, and all patients had inflammation at the umbilicus. Patients were treated with antibiotics perorally (n = 8) and intravenously (n = 7). Umbilical granulation was improved with betamethasone valerate gentamicin sulfate in 3 patients. Abscess under the muscle layer was drained with a Nelaton catheter in 4 patients. Incision of abscess was required in 7 patients. Removal of urachal sinus was performed in 4 patients. No carcinoma and no recurrence of infection were observed for a mean 28-month follow-up period. Histological studies in 4 patients showed squamous cells and fibrous tissue, and adenocyte was not recognized.
Conclusion: All patients improved after drainage, and recurrence was not observed. Although urachal carcinoma usually occurs as adenocarcinoma just near the urinary bladder, adenocyte was not histologically revealed in our 4 patients. Therefore, propriety of prophylactic removal of urachal sinus to prevent infection and carcinoma should be reconsidered.
