Patent Urachus
- PMID: 32491655
- Bookshelf ID: NBK557723
Patent Urachus
Excerpt
Patent urachus refers to one condition in a rare spectrum of disorders referred to as urachal anomalies. These conditions result from the failure of the involution of normal embryologic tissues that serve to empty the fetal bladder. The location and amount of persistent tissue dictate the presenting symptoms. Some of these urachal anomalies are obvious at birth, while others are more subtle and not diagnosed until adulthood or only incidentally discovered after imaging is obtained for other reasons. Historically, surgical resection of urachal anomalies was routinely undertaken, given the potential for malignancy in retained ectopic tissue. Early surgical resection has been challenged by many studies demonstrating not only the low incidence of the condition in general but the even lower chance of future malignancy. Accurate and expeditious diagnosis of urachal anomalies in the child with umbilical wetness, persistent drainage, recurrent urinary tract infections, and recurrent umbilical infections is required to assist with symptom relief, avoid recurrent severe infection, and provide definitive treatment.
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Sections
- Continuing Education Activity
- Introduction
- Etiology
- Epidemiology
- Pathophysiology
- Histopathology
- History and Physical
- Evaluation
- Treatment / Management
- Differential Diagnosis
- Prognosis
- Complications
- Postoperative and Rehabilitation Care
- Consultations
- Deterrence and Patient Education
- Pearls and Other Issues
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References
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- Gleason JM, Bowlin PR, Bagli DJ, Lorenzo AJ, Hassouna T, Koyle MA, Farhat WA. A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. J Urol. 2015 Feb;193(2):632-6. - PubMed
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- Ashley RA, Inman BA, Routh JC, Rohlinger AL, Husmann DA, Kramer SA. Urachal anomalies: a longitudinal study of urachal remnants in children and adults. J Urol. 2007 Oct;178(4 Pt 2):1615-8. - PubMed
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- Copp HL, Wong IY, Krishnan C, Malhotra S, Kennedy WA. Clinical presentation and urachal remnant pathology: implications for treatment. J Urol. 2009 Oct;182(4 Suppl):1921-4. - PubMed
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- Lipskar AM, Glick RD, Rosen NG, Layliev J, Hong AR, Dolgin SE, Soffer SZ. Nonoperative management of symptomatic urachal anomalies. J Pediatr Surg. 2010 May;45(5):1016-9. - PubMed
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- Nogueras-Ocaña M, Rodríguez-Belmonte R, Uberos-Fernández J, Jiménez-Pacheco A, Merino-Salas S, Zuluaga-Gómez A. Urachal anomalies in children: surgical or conservative treatment? J Pediatr Urol. 2014 Jun;10(3):522-6. - PubMed
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