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.