Patent Urachus Repair
Patent Urachus Repair
Patent urachus repair is surgery to correct a ura-chus (a tube that connects the fetal bladder to the umbilical cord) that fails to close after birth.
A patent urachus is an anomaly, and repair is recommended for these defects occurring at birth.
The condition occurs three times more often in male infants than in females.
As fetal development progresses, the urachus, a tube that can measure from 1.2-3.9 in (3-10 cm) long and 0.3-0.4 in (8-10 mm) in diameter, forms, extending from the front dome of the bladder to the umbilicus. Following birth, the tube, adjacent to the umbilical ligaments, closes and itself becomes ligament. Should this closure fail, it may result in several types of urachal remnants. If the urachus remains completely open, it is known as a patent urachus. This type of abnormality makes up 50% of all urachal anomalies.
If the urachus remains open all the way to the bladder, there is the danger that bacteria will enter the bladder through the open tube and cause infection. For this reason, the patent urachus of the infant must be removed.
This anomaly occurs as an isolated event or in association with prune-belly syndrome, in which there is continuous drainage of urine from the umbilicus. If urine freely discharges through the umbilicus, the patent urachus is rarely found. It should be suspected, however, if a local cord is enlarged and affected with edema, or is slow to slough normally. The condition customarily is diagnosed in infants.
The child is given a general anesthetic, after which an incision is made in the lower abdomen.
Surgery for patent urachus repair may require several days’ hospitalization, during which infants can be fed as normal.
Risks are the same as for those patients receiving any anesthesia: a reaction to medication and/or breathing problems. There is also the risk of bladder infection or bladder leaks. In the latter case, a catheter is put in place until the bladder heals.
The outcomes of patent urachus repair in infants are excellent, as a rule, and most children recover rapidly.
Adenocarcinoma— A malignant tumor that originates in the membranous tissue that serves as the covering of a gland.
Antereolateral— Situated in front and to the side.
Patency— The state of being open or unblocked.
WHO PERFORMS THE PROCEDURE AND WHERE IS IT PERFORMED?
Patent urachus repair is performed by the pediatric surgeon in a hospital setting.
Patent urachal anomalies do not usually cause significant morbidity or mortality. However, adenocarcinoma has been reported in adults with urachal remnants, presumably from chronic inflammation and infection. Patency is noted in only 2% of adults.
Sometimes more conservative treatment than surgery is advised, with radical excision reserved for persistent or recurring cases. Because the urachus may not completely close at birth, but may close within the first few months of the infant’s life, observation may be advised before moving forward with surgery.
Campbell, Meredith F. and Patrick C. Walsh, eds. Campbell’s Urology, 8th ed. Philadephia: W.B. Saunders Company, 2002.
Razvi, S., R. Murphy, E. Shlasko, and C. Cunningham-Rundles. “Delayed Separation of the Umbilical Cord Attributable to Urachal Anomalies.” NIH/NLM MEDLINE 108, no.2 (August 1, 2001): 493–494.
Nancy McKenzie, PhD
QUESTIONS TO ASK THE DOCTOR
- Is it advisable to put off surgery during the first few months of the child’s life and see if the urachus will close on its own?
- What effects will surgery have on a newborn?
"Patent Urachus Repair." The Gale Encyclopedia of Surgery and Medical Tests. . Encyclopedia.com. (October 21, 2018). http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/patent-urachus-repair-0
"Patent Urachus Repair." The Gale Encyclopedia of Surgery and Medical Tests. . Retrieved October 21, 2018 from Encyclopedia.com: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/patent-urachus-repair-0
Encyclopedia.com gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).
Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.
Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, Encyclopedia.com cannot guarantee each citation it generates. Therefore, it’s best to use Encyclopedia.com citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:
Modern Language Association
The Chicago Manual of Style
American Psychological Association
- Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most Encyclopedia.com content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
- In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.