What Is a Urachal Cyst?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 24 June 2014
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    Conjecture Corporation
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A urachal cyst is a congenital birth defect where a small fluid-filled cavity remains between the umbilicus and the bladder. It is a remainder of the allantois, the structure used to remove waste during fetal development. In people with urachal cysts, part of the structure remains in place. Often, the patient will be asymptomatic until a problem develops, although sometimes, a urachal cyst will be visible on an ultrasound exam of the abdomen conducted for other reasons.

Usually, a doctor diagnoses this condition in childhood. The patient may experience abdominal pain and tenderness, discharge around the umbilicus, and difficulty urinating. An ultrasound examination will reveal the fluid-filled cavity in a location where one should not be. Commonly, the urachal cyst contracts a bacterial infection, leading to swelling, pain, and irritation for the patient.

One potentially serious concern is the risk of rupture. As long as the urachal cyst remains anchored in place, the patient should remain relatively stable, although infections can cause tissue death and complications like organ failure. If the structure breaks open, it can compress other organs and may potentially be fatal if internal bleeding occurs. In cases of rupture, the patient typically reports an acute onset of pain and discomfort, and may go into shock as a result of internal bleeding.

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The typical treatment for a urachal cyst is surgery to address the abnormality. In patients with infections, the patient may need to remain on antibiotics to stabilize before the surgery can take place. In cases where neighboring tissue dies as a result of the infection, the surgery will include debridement to take this tissue out so it does not cause problems for the patient. The surgeon may be able to work laparoscopically, through a series of small incisions, so scarring will be minimal.

The reasons for urachal cyst formation remain obscure. There do not appear to be any steps people can take during pregnancy to prevent cysts from growing, and they often appear independent of other fetal abnormalities. In cases where a baby has structural anomalies in the urinary tract, the doctor will conduct an ultrasound to check for problems like urachal cysts and kidney malformations, to rule out any associated complications. A pediatric urologist often takes charge of care for this condition, providing parents with advice and information on how to proceed. If the condition is not diagnosed until adulthood, the patient can see a regular urologist to discuss treatment options.

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Discuss this Article

anon327511
Post 3

My son developed a urachal cyst when he was 10 years old. The first signs that something was wrong was slight discomfort in his abdomen followed by blood in his urine. When taken to the ER, the culture showed urinary tract infection and he was treated with antibiotics. A few weeks later the same thing occurred. Same diagnosis. When it happened a third time, we were referred to a pediatric urologist, who believed it was kidney stones by the elevated calcium level in his urine. We changed his diet and watched for a passing kidney stone. Meanwhile, my son's pain level was increasing, and the recurrence of blood in the urine was increasing.

Ultrasounds and a CT scan showed nothing. Three cystoscopies were preformed, each with no result. He was put on morphine for the pain, which could become excruciating, and he was scheduled for exploratory abdominal surgery. That surgery found a "remnant" of what was believed could have been a urachal cyst, and so that tissue was removed, along with some surrounding tissue "just to be sure". A few weeks passed and the same symptoms as before continued.

I rushed him to the emergency when he was in excruciating pain and they did an MRI and found a cyst the size of a golf ball on the dome of his bladder. He had surgery to remove it. What had been happening was the cyst would fill and then expel inside the bladder, causing the pain, and then the blood from the fluid inside the cyst would be present in his urine. It was all timing. When the previous procedures had been preformed, the cyst had already expelled and was lying flat on the bladder wall, undetectable by imaging or surgical view. I had searched the web endlessly for some idea what it could be prior to it being resolved. I post this here to maybe help anyone else who is looking for answers to unconventional symptoms.

tanner182
Post 2

@MissCourt - I'm sure your doctor would take the time to figure out if it was cancer before they made you worry. Besides, some cysts may become cancerous. Until you are thoroughly examined by a doctor, you wouldn't have any way of knowing.

As you said, it's another reason to go to routine checkups. Especially if you have a unusual pain or discomfort down in your abdomen. Easy treatment can be the cure to most health problems. The sooner the doctor can start to find out if it's a cancerous cyst, the sooner it can be dealt with.

MissCourt
Post 1

Ugh, this sounds ugly. How could a doctor tell if urachal cysts were actually urachal cancer? They would both show up as the same thing on an ultrasound and they would both feel hard.

I can't imagine finding one of these in your abdomen and worrying it was cancer -- only to figure out it wasn't. One more reason for routine check ups I guess. Doctors can only figure out what it is if they know it's there.

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