An Overview of Urachal Cyst

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A urachal cyst is a collection of tissue and fluid between the bladder and the belly button (umbilicus). The cyst forms in the remnants of the urachus, a structure normally present in a fetus that usually closes up before birth.

In some infants, the closure doesn't occur. If this happens, a urachal abnormality (such as a cyst or sinus) remains.

People can live comfortably with a urachal cyst their entire life without realizing it, as they usually don't cause any problems. However, drainage from the cyst can cause discomfort or other symptoms.

Infections can also occur. An infected urachal cyst can be a serious condition and needs immediate medical treatment.

Symptoms

Having a urachal cyst does not mean you will have symptoms. Urachal cysts or abscesses usually will only cause symptoms if they become infected.

Symptoms of an infected urachal cyst include:

A severe urachal cyst infection can cause more widespread symptoms, such as abdominal redness and swelling, extreme fatigue, vomiting, and intense abdominal pain.

Rarely, urachal cysts allow urine to drain from the belly button. In newborns, the drainage is usually caused by a problem in the cavity that connects the bladder and the belly button (urachal sinus. It can lead to poor healing of the umbilical cord after birth.

Drainage from a urachal cyst causes a constantly moist belly button, with a yellow fluid coming from the stem of the abdominal fold. If not frequently cleaned, skin reddening and a foul odor may develop.

If you are experiencing symptoms of an infected urachal cyst, you'll need to be evaluated by a medical professional. Without treatment, infected cysts can cause serious health complications.

Causes

In the first trimester of pregnancy, the urachus is a channel between the fetus's bladder and umbilical cord that allows urine to drain from the fetus.

By the third trimester, the urachal channel seals off and becomes the medial umbilical ligament. If the structure remains open, a urachal cyst can result.

Urachal abnormalities are uncommon and usually discovered incidentally during imaging scans and autopsies. They're twice as likely to be found in men than women.

The exact cause of urachal abnormalities is unknown, but it's likely that many factors contribute to their development.

Urachal cysts are a congenital condition (present at birth), so there could be a genetic component. Some research has also suggested the cysts arise due to incomplete development of the urachal area.

Several types of urachal abnormalities can cause symptoms after birth, including:

  • Patent urachus (the remaining connection between the bladder and belly button)
  • Urachal sinus (occurs when the connection between the belly button and the rest of the abdominal area does not seal off)
  • Diverticulum (a lack of closure between the belly button and the bladder)

Any type of urachal defect can become infected. Urachal cyst infections are most commonly seen in children between the ages of 2 and 4 years old.

Urachal abnormalities don't necessarily cause symptoms or require treatment. In many cases, they go unnoticed for years and never cause any problems.

Diagnosis

The presence of a urachal cyst is confirmed through imaging techniques like ultrasounds, magnetic resonance imaging (MRI), and computed tomography (CT) scans. These scans allow doctors to determine whether a cyst is present and problematic.

If your doctor confirms the presence of a urachal cyst and you have symptoms of an infection, you will need further medical care. Your doctor will ask you about your medical history, perform a physical exam, and may order lab tests before prescribing treatment.

Treatment

If you have a urachal cyst that isn't causing symptoms, you don't have to take any specific action. Treatment would only be urgent if the cyst becomes infected.

In this case, antibiotics are required. Most urachal cyst infections can be treated with medications you take by mouth (oral antibiotics). However, if the infection is severe, you may need to get antibiotics through a vein in your arm (intravenous).

Sometimes, an infected urachal cyst needs to be removed surgically. Surgery may be recommended if the cyst causes excessive draining, irritation, discomfort, and/or repeated infection.

Removing the urachal cyst prevents future infections and reduces the risk of urachal cancer (a rare bladder cancer).

Similarly, a draining urachal sinus can be removed and close off (excised) through a small incision of the belly button or with laparoscopic surgery.

Rarely, there have been cases where urachal abnormalities resolved spontaneously without treatment. Since this outcome is not as likely and urachal cysts can cause problems, you should discuss the best course of treatment for your situation with your doctor.

A Word From Verywell

If you have a urachal cyst, you might live your entire life without experiencing any issues. You may not even realize you have one.

However, if the cyst becomes infected it can become a serious medical problem.

If you have symptoms of an infected urachal cyst, including sudden or severe abdominal pain, seek immediate medical care.

Proper treatment is necessary to prevent complications or future issues related to the cyst. Most infections can be treated with antibiotics, but in some cases, a doctor may decide to surgically remove the cyst.

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