Are urachal remnants really rare in children? An observational study

Abstract

Urachal remnants are thought to have a low prevalence. However, recent studies indicate a higher rate. The aim of this study was to evaluate the prevalence of urachal remnants in children referred for imaging by abdominal/urinary/suprapubic ultrasonography in one calendar year. Files of children who underwent abdominal/urinary/suprapubic ultrasonography in one calendar year were retrospectively reviewed. Data regarding children ≤17 years that underwent ultrasonography of the ventral abdominal wall while being assessed for various reasons were collected. Anomalies detected, age, gender, reason for ultrasonography request, and diagnosis of the urachal remnant were noted. All ultrasonography assessments were performed by a single pediatric radiologist in a single institution. There were 4836 patients in the study (1919 boys). Median age of the whole cohort was 7 years. A total of 10 patients were found to have urachal remnants, which included eight urachal cysts (three boys) and two urachal diverticula (one boy).

Conclusion: The prevalence of urachal remnants in our cohort was nearly 2 in every 1000 children. More specifically, the prevalence of urachal cysts was one in 600.

What is Known:
Urachal remnants were believed to be rare.
Recent studies indicated a higher incidence than previous reports.
What is New:
This study shows that urachal remnant may be observed in one every 500 children that undergo ultrasonography of the abdomen for various reasons.
Parental counselling and management of urachal remnants should be planned accordingly.

This is a preview of subscription content, access via your institution.

Fig. 1

Abbreviations

MHz:

Megahertz

UR:

Urachal remnant

US:

Ultrasonography

PACS:

Picture archiving and communication systems

References

  1. 1.

    Ozbek SS, Pourbagher MA, Pourbagher A (2001) Urachal remnants in asymptomatic children: gray-scale and color Doppler sonographic findings. J Clin Ultrasound 29:218–222

    CAS  Article  Google Scholar 

  2. 2.

    Gleason JM, Bowlin PR, Bagli DJ, Lorenzo AJ, Hassouna T, Koyle MA, Farhat WA (2015) A comprehensive review of pediatric urachal anomalies and predictive analysis for adult urachal adenocarcinoma. J Urol 193:632–636

    Article  Google Scholar 

  3. 3.

    Stopak JK, Azarow KS, Abdessalam SF, Raynor SC, Perry DA, Cusick RA (2015) Trends in surgical management of urachal anomalies. J Pediatr Surg 50:1334–1337

    Article  Google Scholar 

  4. 4.

    Cilento BG Jr, Bauer SB, Retik AB, Peters CA, Atala A (1998) Urachal anomalies: defining the best diagnostic modality. Urology 52:120–122

    Article  Google Scholar 

  5. 5.

    Ashley RA, Inman BA, Routh JC, Rohlinger AL, Husmann DA, Kramer SA (2007) Urachal anomalies: a longitudinal study of urachal remnants in children and adults. J Urol 178:1615–1618

    Article  Google Scholar 

  6. 6.

    Dethlefs CR, Abdessalam SF, Raynor SC, Perry DA, Allbery SM, Lyden ER, Azarow KS, Cusick RA (2019) Conservative management of urachal anomalies. J Pediatr Surg 54:1054–1058

    Article  Google Scholar 

  7. 7.

    Nix JT, Menville JG, Albert M, Wendt DL (1958) Congenital patent urachus. J Urol 79:264–273

    CAS  Article  Google Scholar 

  8. 8.

    Ueno T, Hashimoto H, Yokoyama H, Ito M, Kouda K, Kanamaru H (2003) Urachal anomalies: ultrasonography and management. J Pediatr Surg 38:1203–1207

    CAS  Article  Google Scholar 

  9. 9.

    Elmaci AM, Donmez MI (2019) Time to resolution of isolated antenatal hydronephrosis with anteroposterior diameter </= 20 mm. Eur J Pediatr 178:823–828

    Article  Google Scholar 

  10. 10.

    Naiditch JA, Radhakrishnan J, Chin AC (2013) Current diagnosis and management of urachal remnants. J Pediatr Surg 48:2148–2152

    Article  Google Scholar 

  11. 11.

    Collins DC, Velazquez-Kennedy K, Deady S, Brady AP, Sweeney P, Power DG (2016) National Incidence, Management and Survival of Urachal Carcinoma. Rare Tumors 8:6257

    Article  Google Scholar 

  12. 12.

    Pinthus JH, Haddad R, Trachtenberg J, Holowaty E, Bowler J, Herzenberg AM, Jewett M, Fleshner NE (2006) Population based survival data on urachal tumors. The Journal of urology 175:2042–2047 discussion 2047

    Article  Google Scholar 

Download references

Availability of data and material

Data and material of the study is stored in a database and can be shared upon request.

Code availability

N/A

Author information

Affiliations

Authors

Contributions

Both authors contributed equally for this study.

Corresponding author

Correspondence to Muhammet İrfan Dönmez.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Approval for this study was obtained from Necmettin Erbakan University Institutional Board (18.10.2019-2019/2127).

Consent to participate

Informed consent was waived from all individual participants included in the study.

Consent for publication

N/A

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Communicated by: Gregorio Paolo Milani

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Keçeli, A.M., Dönmez, M.İ. Are urachal remnants really rare in children? An observational study. Eur J Pediatr (2021). https://doi.org/10.1007/s00431-021-03962-y

Download citation

Keywords

  • Urachus
  • Remnant
  • Ultrasonography
  • Prevalence
  • Urachal