Malformative diseases of the urachus: About 12 cases collected in a pediatric surgical center of Aristide Le Dantec Hospital in Dakar, Senegal

Abstract

Objectives: to report the epidemiological aspects, diagnosis and treatment of urachal anomalies. Patients and methods: We conducted a retrospective study in Pediatric Surgery department of Hospital Aristide Le Dantec for a period of 15 years. The parameters studied were the prevalence, sex, age, reason for consultation, clinical, paraclinical, treatment, hospital stay and evolution of urachal anomalies. Results: We collected 12 cases of malformative diseases of the urachus, for a prevalence of 0.8 cases/year. Our sample consisted of seven boys and five girls with a sex-ratio of 1.4. The mean age was 1.6 years. We noted a predominance of fistulas of the urachus with 8 cases. Drainage of fluid from the umbilicus was the most common sign in 8 cases. Fistulography was requested for two patients and confirmed the diagnosis of fistula of the urachus. In other cases the diagnosis was made intraoperatively. Surgical treatment was performed in 10 patients and consisted of a laparotomy followed by resection of urachal tissue including a collar of the bladder dome. one case was observed for regression of symptoms. After a mean of 6 months the evolution was marked by the occurrence of an evisceration of infectious origin, three cases of wound infection and two deaths. Conclusions: Anomalies of the urachus are rare in our service. The male is most affected. Drainage of fluid from the umbilicus is the most common sign. Ultrasound should be systematic in the preoperative evaluation and treatment should be surgical.

Keywords:
urachus; malformation; umbilicus; fistula; surgery

African Journal of Urology (2013) 19, 113–118