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International Urogynecology Journal Jun 2015Cystoscopy is frequently performed by gynecologists to ensure ureteral patency and to prevent bladder injury when performing concomitant gynecological procedures....
INTRODUCTION AND HYPOTHESIS
Cystoscopy is frequently performed by gynecologists to ensure ureteral patency and to prevent bladder injury when performing concomitant gynecological procedures. Generally, there are no additional findings on cystoscopy; however, when abnormalities arise, they may require either observation or intervention. Our aim was to create a visual library of benign, malignant, and foreign-body pathological conditions incidentally encountered on cystoscopy.
METHOD
Cystoscopic findings were videotaped at the time of routine surgical care. Regarding Institutional Review Board approval, individual consent was waived as the videos were de-identified and collected for educational purposes.
RESULTS
Benign pathological conditions: squamous metaplasia, duplicated ureteral orifice, ureterocele, Hutch diverticulum, bladder trabeculation, urachal cyst, interstitial cystitis with and without Hunner's lesion, endometriosis in the bladder, port-wine stain due to Klippel-Trénaunay-Weber syndrome, nephrogenic (mesonephric) metaplasia, and cystitis glandularis (intestinal metaplasia). Malignant pathological conditions: papillary urothelial neoplasm of low malignant potential (PUNLMP), carcinoma in situ (CIS), high-grade urothelial carcinoma, and urachal cancer. Foreign-body pathological conditions: edema from ureteral stents and stone-encrusted mesh.
CONCLUSION
This video is intended to educate the audience on some incidental bladder findings seen on female cystoscopy. Many pathological conditions can be biopsied or treated immediately during the procedure; hence, early urology consultation is encouraged for most abnormalities.
Topics: Cystitis, Interstitial; Cystoscopy; Female; Foreign Bodies; Gynecologic Surgical Procedures; Humans; Incidental Findings; Intraoperative Complications; Urethra; Urinary Bladder; Urinary Bladder Diseases; Urinary Bladder Neoplasms
PubMed: 25619539
DOI: 10.1007/s00192-014-2614-4 -
Medicina (Kaunas, Lithuania) Nov 2022Patent urachus is a type of urachal anomaly in which the urachus does not tail off but remains connected to the bladder in the umbilicus. The prevalence of patent... (Review)
Review
Patent urachus is a type of urachal anomaly in which the urachus does not tail off but remains connected to the bladder in the umbilicus. The prevalence of patent urachus is very low. Herein, we report a case of patent urachus ruptured and exposed to amniotic fluid in utero. In this case, the size decreased after the second trimester, which was thought to be due to rupture in utero. After delivery, patent urachus was confirmed by inserting a foley catheter, which runs through a ruptured cyst on umbilical cord insertion. The day after delivery, the neonate underwent surgical excision of the urachal cyst and closing umbilicus. The mechanism of patent urachus rupture is unknown. As the fetus matures, it is thought that the higher intravesical pressure may affect the rupture of the cyst. Patent urachus could be ruptured in the uterus spontaneously, and surgical correction is needed. Therefore, prenatal differential diagnosis is important.
Topics: Infant, Newborn; Pregnancy; Female; Humans; Urachus; Urachal Cyst; Pregnancy Trimester, Second; Urinary Bladder; Ultrasonography, Prenatal
PubMed: 36363578
DOI: 10.3390/medicina58111621 -
BMC Urology Sep 2021To investigate the feasibility and efficacy of carrying out pediatric laparoscopic partial cystectomies (LPC) when treating benign bladder tumors and urachal cysts.
OBJECTIVE
To investigate the feasibility and efficacy of carrying out pediatric laparoscopic partial cystectomies (LPC) when treating benign bladder tumors and urachal cysts.
METHODS
Retrospectivey analyzing 4 clinical cases involving children with bladder tumors, which were collected from October 2017 to December 2018. In these clinical cases, there were 3 male children and 1 female child, aged from 4.5 to 9.4 years old, with an average age of 6.5 years. An intraperitoneal laparoscopic partial cystectomy was performed in the treatment of 3 of these patients with benign bladder tumors and in 1 patient with an urachal cyst. The surgical procedures included a partial cystectomy and a complete intracavitary bladder suture.
RESULTS
All 4 cases were successful and no operation was transferred to opensurgery. The operation time was 100-120 min, with an average time of 108 min. The intraoperative blood loss was 10-20 ml, with an average loss of 15 ml. 6 h after the operation, the patients still maintained a fluid diet and 1 case of hematuria had occurred, with the catheter removed 12 days after the operation. No postoperative urine leakage, intestinal adhesion or intestinal obstruction occurred, and the average postoperative hospitalization time was 14 days.
CONCLUSION
Laparoscopic partial cystectomy is a safe and feasible method to be used for the treatment of benign bladder tumors and urachal cysts. It presents the advantages of being minimally invasive, and having a quick recovery and short hospitalization time. It is an alternative surgical method for the treatment of pediatric benign bladder tumors.
Topics: Blood Loss, Surgical; Child; Child, Preschool; Cystectomy; Feasibility Studies; Female; Hematuria; Humans; Laparoscopy; Male; Operative Time; Retrospective Studies; Urachal Cyst; Urinary Bladder Neoplasms
PubMed: 34526006
DOI: 10.1186/s12894-021-00893-6 -
BMC Pediatrics Mar 2023A urachal cyst has a rare incidence that has been reported as 1/5,000 live birth.
BACKGROUND
A urachal cyst has a rare incidence that has been reported as 1/5,000 live birth.
CASE PRESENTATION
We report two patients with a complicated urachal cyst, a 5-year-old female who presented to the emergency department with severe abdominal pain and a 3-year-old female presenting with abdominal pain and constipation. Upon laparoscopic exploration both patients had complicated urachal cysts which were adherent to the urinary bladder.
CONCLUSION
Complicated urachal cysts can present with acute abdominal pain.
Topics: Female; Humans; Child; Child, Preschool; Urachal Cyst; Abdominal Pain; Abdomen, Acute; Laparoscopy; Emergency Service, Hospital
PubMed: 37004016
DOI: 10.1186/s12887-023-03962-x -
International Journal of Surgery Case... Dec 2022Urachal cyst (UC) sinus occur secondary failed regression of allantois's embryonal canal during fetal development. Several types depending on the arrest level and...
INTRODUCTION AND IMPORTANCE
Urachal cyst (UC) sinus occur secondary failed regression of allantois's embryonal canal during fetal development. Several types depending on the arrest level and connection to the urogenital tract. Umbilical urachal sinus is characterized in less than 15 % of cases. An infected urachal sinus patient can present with umbilical sinus and purulent discharge with various emergency presentations and scenarios.
CASE PRESENTATION
A 26-year-old Sudanese male, a healthy athlete, presented two weeks before the last presentation with periumbilical discomfort, and umbilical discharge increased with physical activity. He was first seen in the outpatient clinic and diagnosed with an uncomplicated umbilical cyst. One week later, periumbilical pain became throbbing, severe with a dragging sensation, and skin erythema. His swelling produced purulent discharge with concomitant low-grade fever. He denied any past medical, surgical, or family history. An ultrasound scan revealed a periumbilical cyst confirmed by CECT consistent with an infected urachal sinus. Surgical excision of the cyst and umbilicoplasty was achieved with an uneventful postoperative course.
CLINICAL DISCUSSION
Urachal sinuses may vary in their presentation according to the anomaly and clinical effect. It can be daunting to diagnose, even with the availability of CECT modalities. Conservative management can be of benefit in case of incidental findings, but surgical management is the preferred approach for complicated patients. A laparoscopic approach is the recommended treatment.
CONCLUSION
Our case report shows that serious complications can be prevented with early diagnosis, management, and prompt surgical intervention if this rare diagnosis is kept in mind.
PubMed: 36436421
DOI: 10.1016/j.ijscr.2022.107784 -
Chonnam Medical Journal Apr 2013Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We...
Managing persistent and symptomatic urachal anomalies requires wide surgical excision of all anomalous tissue with a cuff of bladder tissue via the open approach. We report 7 cases with complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue. We expected that this technique would be less invasive and have lower morbidity. We report on the feasibility of this approach, including efficacy and outcomes. Eight patients with a mean age of 36.5 years who had symptomatic urachal diseases underwent laparoscopic excision between July 2004 and July 2012. With the use of four ports, the urachal remnant was dissected transperitoneally and then removed via the umbilicus port. The clinical results of laparoscopic urachal remnant excision as a minimally invasive surgery, the perioperative records, and pathologic results were evaluated. There were no intraoperative or postoperative complications. Mean surgery time was 2.7 hours. Mean hospital stay was 14.6 days. The patients with bladder cuff resection had a long admission and Foley catheterization period (mean, 14.4 and 11 days). Pathological evaluations were 6 cases of infected urachal cysts, 1 case of infected urachal sinus, and 1 case of urachal adenocarcinoma. We found no postoperative complications including any symptom recurrence or voiding difficulty during a mean follow-up of 46.3 months. The perioperative surgical outcomes achieved infection control and symptomatic relief and additionally good cosmesis. Complete laparoscopic removal of symptomatic urachal remnants with or without a cuff of bladder tissue seems to be a safe, effective, and better cosmetic alternative with the advantages of a minimally invasive approach.
PubMed: 23678477
DOI: 10.4068/cmj.2013.49.1.43 -
Cureus May 2020Urachus is an embryonic organ related to the bladder that degenerates after birth. Defective obliteration of the urachus leads to urachal malformations, the most common...
Urachus is an embryonic organ related to the bladder that degenerates after birth. Defective obliteration of the urachus leads to urachal malformations, the most common of which is a urachal cyst. A urachal cyst is often misdiagnosed due to its myriad presentations. Delay in diagnosis can lead to complications such as sepsis, fistula formation, and rupture of the cyst mimicking peritonitis. Hence, a high index of suspicion is required for the timely diagnosis and management of urachal cysts presenting in the emergency room. We report the case of a 32-year-old woman who presented with clinical features suggestive of an acute abdomen. The judicious use of imaging confirmed the diagnosis of an infected urachal cyst, which was surgically managed.
PubMed: 32582481
DOI: 10.7759/cureus.8220 -
Journal of Surgical Case Reports Mar 2018Urachal remnant diseases are very uncommon pathologies which are mostly benign. Rarely they can progress to a very aggressive form of Urachal cancer. The rarity of this...
Urachal remnant diseases are very uncommon pathologies which are mostly benign. Rarely they can progress to a very aggressive form of Urachal cancer. The rarity of this condition has precluded large studies to help guide the diagnostic and therapeutic management of these potentially malignant lesions. In this case, a urachal cyst was discovered and conservative management was employed after a biopsy proved the lesion was benign. Unfortunately this patient represented several years later with a locally advanced urachal cancer. To date, this is the first clearly documented case of malignant transformation. The available literature surrounding these urachal cysts and cancers will be reviewed to determine if anything could have been done differently in this case and in the future should a similar case present.
PubMed: 30271532
DOI: 10.1093/jscr/rjy056 -
Journal of the Belgian Society of... 2023Infected urachal cysts are a rare cause of abdominal complaints and can be accurately diagnosed by abdominal ultrasound and computed tomography (CT).
Infected urachal cysts are a rare cause of abdominal complaints and can be accurately diagnosed by abdominal ultrasound and computed tomography (CT).
PubMed: 36817568
DOI: 10.5334/jbsr.3029 -
Journal of Medical Case Reports Mar 2014Urachal cysts are rare congenital anomalies that often prompt referral to the paediatric general surgeon because of their associated complications such as infection,...
INTRODUCTION
Urachal cysts are rare congenital anomalies that often prompt referral to the paediatric general surgeon because of their associated complications such as infection, abdominal pain and the young age at presentation. In this report we describe a rare case of fever of unknown origin caused by an urachal cyst which was successfully treated with incision and drainage only. Since the first description of urachal anomalies by Cabriolus in 1550, few cases have been reported and, until now, only one case of infected urachal cyst presenting as fever of unknown origin has been described in the literature. Moreover, the spontaneous resolution of an urachal cyst without excision is extremely rare.
CASE PRESENTATION
We report our experience in the management and treatment of an infected urachal cyst that occurred in a 12-year-old Caucasian girl who presented to our Department of Paediatric Surgery with a 30-day history of evening fever. The urachal cyst was treated only with incision and drainage through a minimally invasive laparoscopic approach.
CONCLUSIONS
The incision and drainage of an infected urachal cyst is a simple and safe procedure. It assures a complete recovery and avoids potential surgical complications related to the total excision of the urachal cyst. This report may provide important clues regarding the management of this rare anomaly and we emphasise the importance for paediatricians, who should consider the possibility that a fever of unknown origin can be caused by an urachal cyst, and for surgeons and urologists, because it suggests that conservative treatment of this rare anomaly should be considered when possible.
PubMed: 24661549
DOI: 10.1186/1752-1947-8-106