Relevance of infection in children with urachal cysts

Objective: To assess the role of infection in the management of children wi th urachal cysts. Methods: A retrospective study on 10 children with urachal cysts operated o n over an 11-year period (from 1987 to 1998) was performed. Uncomplicated u rachal cysts were found in 2 children who underwent primary cyst removal. T he remaining 8 were admitted with severe sepsis due to the presence of a ur achal abscess; they were managed by a staged approach including percutaneou s drainage and delayed cyst removal. The diagnosis of urachal cyst was read ily made by ultrasound in all the 10 patients (100%). In 1 patient with ura chal abscess, computed tomography provided additional information. Results: The postoperative course was uneventful in 9 of 10 children (90%). A 5-year-old female patient developed peritonitis following urachal absces s rupture into the peritoneal cavity, which resulted in additional surgery and prolonged hospitalization. Conclusions: (1) Ultrasound is an excellent diagnostic tool for patients wi th urachal cysts. (2) A renal screening ultrasound must be included in the preoperative work-up. (3) A thorough urological assessment is indicated in patients with abnormal renal ultrasound of recurrent urinary infections. (4 ) At present, a staged surgical procedure still remains the most effective surgical option in children with urachal cyst. Copyright (C) 2000 S. Karger AG, Basel.