2018 Volume 54 Issue 2 Pages 236-241
Purpose: To discuss indications for delayed excision of urachal remnants.
Methods: Twenty-five patients underwent excision of possible urachal remnants. Medical records including operative findings, histopathological findings, and final diagnosis were examined.
Results: The ages of the 25 patients, i.e., 21 male and 4 female patients, ranged from 20 days to 19 years (median, 9 years). Operation was performed 3 weeks to 41 months (median, 3 months) after initial treatments in these patients, of whom 2 patients underwent operation 16 and 41 months after repeated infections. The operative findings were urachal remnants in 10 (40%) patients, i.e., urachal sinus in 5, cyst in 3, and vesicourachal diverticulum in 2 patients. Histopathological examination showed lumen and epithelia compatible with urachal remnants in 9 patients. In 15 (60%) patients, the operative findings were not conclusive for the presence of urachal remnants. The median umbilical ligament with or without scar tissues was excised in 2 patients with scar tissues and in 13 patients without scar tissues. Histopathological evidence of urachal remnants was present in 7 patients. Owing to the absence of such evidence, the final diagnosis was omphalitis unrelated to urachal remnants in the remaining 8 patients. There were more children with omphalitis among those younger than 3 years.
Conclusions: It is relevant to perform urachal remnant excision in patients older than 3 years of age. Conservative treatments are recommended in patients younger than 3 years except those with repeated infections because urachal remnants are unlikely to be related to umbilical infections.
