Patent Urachus Repair
Definition
Patent urachus repair is surgery to correct a urachus (a tube that connects the fetal bladder to the umbilical cord) that fails to close after birth.
Purpose
A patent urachus is an anomaly, and repair is recommended for these defects occurring at birth.
Demographics
The condition occurs three times more often in male infants than in females.
Description
As fetal development progresses, the urachus, a tube that can measure from 1.2–3.9 in (3–10 cm) long and 0.3–0.4 in (8–10 mm) in diameter, forms, extending from the front dome of the bladder to the umbilicus. Following birth, the tube, adjacent to the umbilical ligaments, closes and itself becomes ligament. Should this closure fail, it may result in several types of urachal remnants. If the urachus remains completely open, it is known as a patent urachus. This type of abnormality makes up 50% of all urachal anomalies.
If the urachus remains open all the way to the bladder, there is the danger that bacteria will enter the bladder through the open tube and cause infection. For this reason, the patent urachus of the infant must be removed.
Diagnosis/Preparation
This anomaly occurs as an isolated event or in association with prune-belly syndrome, in which there is continuous drainage of urine from the umbilicus. If urine freely discharges through the umbilicus, the patent urachus is rarely found. It should be suspected, however, if a local cord is enlarged and affected with edema, or is slow to slough normally. The condition customarily is diagnosed in infants.
The child is given a general anesthetic, after which an incision is made in the lower abdomen.
Aftercare
Surgery for patent urachus repair may require several days' hospitalization, during which infants can be fed as normal.
Risks
Risks are the same as for those patients receiving any anesthesia: a reaction to medication and/or breathing problems. There is also the risk of bladder infection or bladder leaks. In the latter case, a catheter is put in place until the bladder heals.
Normal results
The outcomes of patent urachus repair in infants are excellent, as a rule, and most children recover rapidly.
