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Tobu S, Udo K, Nishihara K, Miyajima S, Ando T, Onizuka C, Itesako T, Ashikari A, Hakariya T, Igawa T, Tanaka M, Shin T, Kamoto T, Nakagawa M, Saito S, Sakai H, Eto M, Kamba T, Fujimoto N, Noguchi M. Surveillance of urachal abscess in the Kyushu-Okinawa area of Japan. Int J Urol 2021; 28:1008-1011. [PMID: 34291508 DOI: 10.1111/iju.14637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 05/28/2021] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To report a multicenter experience with the management of urachal abscess treatment in Japan. METHODS This was a retrospective study of 263 cases of urachal abscess managed at 12 university hospitals in the Kyushu-Okinawa region over a 10-year period. Age, sex, abscess size, clinical symptoms, type of urachal remnants, and treatment were collected and analyzed. RESULTS The average age was 29.8 ± 18.1 years, with males accounting for approximately two-thirds of the study population. The average abscess size was 1.7 cm (range 0-11 cm). The most common presenting symptom was umbilical secretion (66%), followed by abdominal pain (46%). A total of 127 patients (48.3%) were treated with antibiotics alone, whereas 136 patients (51.7%) received surgical treatment. The surgical approach was laparotomy in 75 patients (61.0%) and laparoscopic surgery in 48 patients (39.0%). Regarding the type of urachal remnant, the urachus sinus (180 patients) accounted for 68.4% of the total. CONCLUSIONS To our knowledge, this study represents the first report on urachal abscess treatment in Japan. Our data show that the clinical symptoms might vary depending on the type of urachus remnant. It should be noted that gross hematuria, a characteristic symptom of urachal cancer, is rare in patients with urachal abscess.
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Affiliation(s)
- Shohei Tobu
- Department of Urology, Faculty of Medicine, Saga University, Saga, Japan
| | - Kazuma Udo
- Department of Urology, Faculty of Medicine, Saga University, Saga, Japan
| | - Kiyoaki Nishihara
- Department of Urology, Kurume University School of Medicine, Kurume, Japan
| | - Shigero Miyajima
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Tadasuke Ando
- Department of Urology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Chie Onizuka
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Toshihiko Itesako
- Department of Urology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Asuka Ashikari
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Tomoaki Hakariya
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tsukasa Igawa
- Department of Urology, Kurume University School of Medicine, Kurume, Japan
| | - Masatoshi Tanaka
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshitaka Shin
- Department of Urology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Toshiyuki Kamoto
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Masayuki Nakagawa
- Department of Urology, Faculty of Medicine, Kagoshima University, Kagoshima, Japan
| | - Seiichi Saito
- Department of Urology, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan
| | - Hideki Sakai
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomomi Kamba
- Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Naohiro Fujimoto
- Department of Urology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Mitsuru Noguchi
- Department of Urology, Faculty of Medicine, Saga University, Saga, Japan
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Almas T, Khan MK, Fatima M, Nadeem F, Murad MF. Urachal Sinus Complicated by an Umbilical Abscess. Cureus 2020; 12:e9527. [PMID: 32905066 PMCID: PMC7466011 DOI: 10.7759/cureus.9527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The urachal sinus is a vestigial remnant that ensues in the aftermath of incomplete obliteration of the embryonic urachus. Urachal sinuses often remain asymptomatic, being discovered incidentally in instances where they are complicated with a superimposed infection or abscess. Due to their rare occurrence in adults, urachal sinuses are rarely included in the list of differential diagnosis surrounding umbilical pain in adult patients. We hereby delineate a unique case of a urachal sinus in a 26-year-old male patient. Due to the presence of an abscess in a hirsute male, a presumptive diagnosis of an umbilical pilonidal sinus was suspected. However, further diagnostic workup divulged an unequivocal diagnosis of a urachal sinus complicated by an abscess formation.
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Affiliation(s)
- Talal Almas
- Internal Medicine, Royal College of Surgeons in Ireland, Dublin, IRL
| | - Muhammad Kashif Khan
- Surgical Oncology, Federal Government Poly Clinic (Post Graduate Medical Institute), Islamabad, PAK.,Surgical Oncology, Maroof International Hospital, Islamabad, PAK
| | - Mishal Fatima
- Obstetrics and Gynecology, Rawalpindi Medical University, Rawalpindi, PAK
| | - Faisal Nadeem
- General Surgery, Maroof International Hospital, Islamabad, PAK
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Abstract
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.
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Affiliation(s)
- Sruthi Jayakumar
- Epidemiology and Public Health, Chest Research Foundation, Respiratory Research Network, Pune, IND
| | - Danny Darlington
- Urology, Pondicherry Institute of Medical Sciences, Pondicherry, IND
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Ninitas P, Anselmo MP, Silva ACE, Ferreira AIS, Santos JF. Urachal abscess mimicking malignant tumor: can imaging tell them apart? Acta Radiol Open 2019; 8:2058460119852923. [PMID: 31258932 PMCID: PMC6589978 DOI: 10.1177/2058460119852923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/04/2019] [Indexed: 11/30/2022] Open
Abstract
The urachus is an embryonic remnant that usually involutes before birth. Abnormal persistence of this structure can lead to infectious or neoplastic complications later in life. We report a case of an 84-year-old man that presented with a urachal complex mass which, after proper investigation, revealed to be a urachal abscess. Urachal abscesses are rare and usually occur in severe infections. Urachal abscesses can be indistinguishable from urachus carcinoma on imaging studies. This article reviews the clinical and imaging aspects of urachal abscess and carcinoma and possible differentiating elements in imaging. However, definitive diagnosis usually depends on a biopsy or fluid aspiration.
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Affiliation(s)
- Pedro Ninitas
- Department of Radiology, Hospital de Santa Maria, Lisbon, Portugal
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