Urachal Anomalies:

While in the womb, there is a canal-like connection between the navel and the bladder (urinary bladder) (urachal canal). This canal closes during the third month of pregnancy. When there are problems with the closure of this connection, three types of diseases arise.

1. Urachal fistula (open urachus): The closure does not occur, and the connection between the bladder and the navel persists, manifesting as urine leakage from the navel. The most appropriate method for detecting this is to administer a special dye through a thin catheter inserted into the opening where the leakage occurs and take an X-ray in the lateral position. If the canal is open, the dye will be seen to reach the bladder from this point. The treatment involves surgically removing the canal.
2. Urachal sinus: Sometimes the connection between the canal and the bladder may be closed, but only the umbilical part remains open. The umbilicus is always moist. It may sometimes be seen with a small granuloma. Treatment involves the extraperitoneal removal of the sinus.
3. Urachal cyst: In some cases, secretions from the canal wall may lead to the formation of a cystic structure under the umbilicus. In these children, clear fluid may come from the umbilicus, or the cystic structure may become infected. It often presents as a mass between the umbilicus and the symphysis pubis. Ultrasonography and cystography are used for diagnosis. Treatment involves surgical removal of the remnant.

 

How are urachal pathologies diagnosed?

The diagnosis is made based on the patient's medical history and physical examination. Sometimes, ultrasound and voiding cystography may be required to confirm the diagnosis.

How are urachal pathologies treated?

Treatment involves surgically removing the pathology up to the bladder. The surgery can be performed either open or laparoscopically.

Can Urachal Surgery Be Performed Laparoscopically (Closed)?

Yes, it can.

Are There Any Advantages of Laparoscopic (Closed) Surgery Over Open Surgery?

Yes, there are. The main advantages are listed below:

• Less pain
• Less bleeding
• Less infection
• Less scarring, or even no scarring at all
• Shorter hospital stay
• Faster and easier recovery

How is laparoscopic (closed) surgery performed?

The abdomen is inflated with carbon dioxide (CO2) gas through small incisions in the abdomen to create a large space inside the abdomen. Three incisions, one of which is through the navel, are made in appropriate locations on the skin, each measuring 0.3-1 cm in width, and new tubes are inserted. Through these newly added tubes, “long surgical instruments” are inserted to perform the planned surgery.

However, it should be noted that when performed by inexperienced individuals, laparoscopy can lead to more serious complications.

How is follow-up performed after urachal surgery?

The patient is usually fed 6-8 hours after surgery. The patient is discharged home 24-48 hours later. At home, the patient takes painkillers for a few days, does not need to do anything else, and continues their normal life.

What are the risks and complications of urachal surgery?

Since the patient will receive anesthesia, there may be associated risks and complications (such as breathing difficulties or heart problems).

When performed surgically according to standard procedures, problems are generally not encountered.

Does Urachus Surgery Recur?

It generally does not recur when performed by experienced individuals according to standard procedures.

Congenital Prepubic Sinus: This is a rare anomaly, and its cause is not known for certain. There is a sinus opening at the base of the penis. The sinus may be 4-5 cm long, extending toward the navel, and has no connection to the bladder. If infected, it may produce a purulent (inflammatory) or mucous discharge. Diagnosis is based on medical history and physical examination. Treatment involves surgical removal of the pathology.

*** The information provided here is intended to inform visitors, particularly families, about the content of the website. No information should be considered as advice by visitors and should not lead to any decisions or actions. Families should have their child examined by a pediatric surgeon, consult with them, and make decisions based on their individual advice.