An urachal cyst is a birth defect wherein a minute fluid filled cavity or sinus remains in between the urinary bladder and the umbilicus. It is a remnant of the allantois, (which helped eliminate waste during fetal development).
By and large, the case will be asymptomatic, though occasionally, urachal cyst may be apparent on an ultrasound examination carried out for another reason. In some cases, there may be clinical features. Urachal cysts are typically uncommunicative clinically, until infection, stone or adenocarcinoma develops.
What Causes Urachal Cyst?
The cause for the development of urachal cyst is difficult to understand. They habitually occur independent of other fetal anomalies. In case a baby has structural abnormalities in the urinary tract, the doctor will carry out an ultrasound examination to look for problems such as urachal cysts and malformation of the kidney.
A pediatric urologist will manage this condition, giving the parents with information and advice as to how to proceed. If the cyst remains undiagnosed until adulthood, he can then visit a regular urologist to talk about the treatment options.
An urachal cyst originates when a pouch of fluid or sometimes air collects in the urachus. During fetal development, the urachus is a primordial arrangement that links the urinary bladder and the umbilical cord in order to get rid of wastes. Normally, the urachus vanishes before birth; however, a segment of the urachus may remain in some individuals after they are born.
Urachal cysts may occur at any age, but are characteristically seen in older children and adults. The cyst is usually benign; on the other hand, sometimes it could turn in to a cancerous condition. Thus, doctors advice surgery to do away with a urachal cyst.
Signs And Symptoms Of Urachal Cyst
Usually, an urachal cyst is asymptomatic; however, sometimes there may be a few manifesting features:
- Pain in the lower portion of the abdomen.
- Constant discharge from the umbilicus.
- Urinary tract infection
- Blood in the urine
- Pain while urinating
- Lump near the umbilicus
- Fever
Usually, a doctor will diagnose this condition in childhood. The child may complain of abdominal discharge from the umbilicus and difficulty in urination. An ultrasound image will disclose the fluid filled cavity. Frequently, an urachal cyst tends to get infected, resulting in pain, inflammation and irritation.
A potentially grave concern for most doctors is the risk of the cyst rupturing. As long as the cyst stays fixed in place, the individual will be comparatively stable, even though infections can trigger tissue death and even serious complications such as organ failure.
If the urachal cyst ruptures and opens up, it can squeeze and constrict other adjacent organs and can be fatal if internal bleeding occurs. If there is cyst rupture, the individual will complain of sudden, severe pain and may even go in to shock due to the internal bleeding.
How To Treat Urachal Cyst?
By and large, the usual treatment for an urachal cyst is surgery. Surgical intervention will get rid of the cyst easily. Those having infection need to be put on antibiotics prior to the surgery.
In those cases where the adjoining tissue dies due to the infection, the surgery will comprise of debridement of this dead tissue as well. Surgery is usually done via a laparoscope through a series of tiny incisions, so that scarring is minimum.