Urachal Sinus Surgery: Clinical Picture

Clinical Image

Austin J Urol. 2021; 7(2): 1070.

Urachal Sinus Surgery: Clinical Picture

Mohammed M*, Dieudonné ZOJ*, Jaafar M, Youness R, Mustapha A, Soufiane M, Fadl TM, Eddine EJ, Jamal EM and Hassan FM

Urology Division, Teaching Hospital Hassan 2, Fez, Morocco

*Corresponding author: Mzyiene Mohammed, Urology Division, CHU Hassan 2, Fez, Morocco

Ziba Ouima Justin Dieudonné, Urology Division, CHU Hassan 2, Fez, Morocco

Received: July 09, 2021; Accepted: July 24, 2021; Published: July 31, 2021

Keywords

Urachus, Sinus, Cyst, Allantois, Umbilicus

Clinical Image

The urachus is a fibrous cord, a remnant of the duct, which in the embryo, connects the bladder with the allantois duct [1]. The urachus can be the site of two types of lesions: on the one hand, congenital anomalies resulting from a defect in the obliteration of the allantois duct (diverticula, fistulas, cysts, sinus), and on the other hand, acquired lesions, essentially of a tumoral nature and most often malignant (urachus carcinoma) [2].

We report the clinical picture of a 28-year-old patient, with a history of uropathology since childhood (hypospadias), chronic renal failure since 2017 under dialysis, neobladder type Mitrofanoff since 2009, admitted for the management of an umbilical abscessed collection. Abdominal MRI revealed a superinfected urachus sinus. The treatment consisted of complete open excision of the sinus (Figure 1) from the umbilicus to the urinary bladder. The postoperative course was simple.

Figure 1: The resected specimen (urachal sinus (black arrow), bladder wall (white arrow).

    

    
    

    

    Figure 1: The resected specimen (urachal sinus (black arrow), bladder wall
(white arrow).

A purulent umbilical discharge is often indicative of the presence of a urachus sinus; ultrasound and fistulography are sufficient for the diagnosis [3]. Excision of the urachus sinus by surgery is the standard treatment in this clinical situation [4].

References

  1. Parada Villavicencio C, Adam SZ, Nikolaidis P, Yaghmai V, Miller FH. Imaging of the Urachus: Anomalies, Complications, and Mimics. Radiogr Rev Publ Radiol Soc N Am Inc. 2016; 36: 2049-2063.
  2. Das JP, Vargas HA, Lee A, Hutchinson B, O’Connor E, Kok HK, et al. The urachus revisited: multimodal imaging of benign & malignant urachal pathology. Br J Radiol. 2020; 93: 20190118.
  3. Buddha S, Menias CO, Katabathina VS. Imaging of urachal anomalies. Abdom Radiol N Y. 2019; 44: 3978-3989.
  4. Surgical strategy of urachal remnants in children. 2021.

Citation: Mohammed M, Dieudonné ZOJ, Jaafar M, Youness R, Mustapha A, Soufiane M, et al. Urachal Sinus Surgery: Clinical Picture. Austin J Urol. 2021; 7(2): 1070.