Laparoscopic management of symptomatic urachal remnants in adulthood. 2015

Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
Department of Surgery, Sarawak General Hospital, Kuching, Malaysia. Electronic address: szeli18@yahoo.com.

BACKGROUND The traditional surgical approach to the excision of persistent urachal remnants is a lower midline laparotomy or semicircular infraumbilical incision. The aim of this study is to report our experience with laparoscopic urachus excision as a minimally invasive diagnostic and surgical technique. METHODS This study was a prospective study involving patients who were diagnosed with persistent urachus and underwent laparoscopic excision. The morbidity, recovery, and outcomes of surgery were reviewed. RESULTS Fourteen patients (8 men) with a mean age of 22.8 ± 6.42 years underwent laparoscopic excision. All patients presented with discharge from the umbilicus. Although four patients had no sonographic evidence of a patent urachus, a diagnostic laparoscopy detected a patent urachus that was excised laparoscopically. One patient required laparoscopic reoperation for persistent discharge, and one patient presented with bladder injury, which was repaired via a small Pfannenstiel incision without any morbidity. The mean operative time was 71.1 ± 0.28 minutes, and the mean duration of hospital stay was 1.3 ± 1.38 days. Pathological examination confirmed a benign urachal remnant in all cases. CONCLUSIONS Laparoscopy is a useful alternative for the management of persistent or infected urachus, especially when its presence is clinically suspected despite the lack of sonographic evidence. The procedure is associated with low morbidity, although a small risk of bladder injury exists, particularly in cases of severe active inflammation. Recurrence is uncommon and was caused by inadequate excision of inflammatory tissue in our series that was easily managed laparoscopically.

UI MeSH Term Description Entries
D008297 Male Males
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014497 Urachus An embryonic structure originating from the ALLANTOIS. It is a canal connecting the fetal URINARY BLADDER and the UMBILICUS. It is normally converted into a fibrous cord postnatally. When the canal fails to be filled and remains open (patent urachus), urine leaks through the umbilicus.
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

Related Publications

Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
December 2006, International journal of urology : official journal of the Japanese Urological Association,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
September 2014, Journal of endourology,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
April 2013, Chonnam medical journal,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
December 2005, BJU international,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
October 2012, World journal of urology,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
November 2000, The Journal of urology,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
March 2009, Actas urologicas espanolas,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
May 2012, Actas urologicas espanolas,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
June 2018, Medicine,
Sze Li Siow, and Hans Alexander Mahendran, and Mark Hardin
May 2007, The Journal of urology,
Copied contents to your clipboard!