Urachal Remnant

What is a urachal remnant?

All fetuses have a urachus (yer-AA-kus), a temporary channel between the bladder and belly button that drains urine (pee). During the second trimester of pregnancy, the channel breaks down into a small cord of fibrous tissue, called the median umbilical ligament, and is present throughout a healthy individual’s lifetime. But in some cases, the tissue remains after birth and is called a urachal remnant.

How common is it?

While researchers don’t know the exact number, they estimate that urachal remnants occur in about 1% of children. Urachal remnants tend to be more common in males than females.

Are there different kinds of urachal remnants?

A urachal remnant may be:

• Completely open (patent urachus).
• Filled with tissue and fluid (urachal cyst).
• Open at the belly button but closed at the bladder (urachal sinus).
• Open at the bladder (vesicourachal diverticulum).

Does a urachal remnant need to be removed?

A urachal remnant can lead to problems for some children and adults. A healthcare provider might decide that surgically removing the remnant is necessary.

However, each person’s situation is different. A healthcare provider can perform a comprehensive assessment to help figure out what’s best for you or your child.

What causes a urachal remnant?

Experts aren’t sure why some babies end up with a urachal remnant after birth.

What are the symptoms of a urachal remnant?

In many cases, a urachal remnant doesn’t cause any noticeable symptoms. Symptoms may also depend on the type of urachal remnant.

Some newborns may have wetness around their belly button that doesn’t go away.

Older children and adults might have these urachal remnant symptoms:

• Fever.
• Frequent urinary tract infections. (UTIs in children may differ slightly from UTIs in adults.)
• Lower abdominal (belly) pain.
• Painful urination.

When is a urachal remnant diagnosed?

Healthcare providers may diagnose a urachal remnant in newborns or young children if they have symptoms. In many cases, people aren’t diagnosed until adolescence or adulthood, if complications occur.

How is a urachal remnant diagnosed?

Healthcare providers usually discover a urachal remnant when they’re checking for a different concern or condition. If your provider notices something unusual, they’ll do further testing to confirm a diagnosis.

What tests diagnose a urachal remnant?

To diagnose a urachal remnant, healthcare providers commonly perform an ultrasound of your belly, bladder and pelvis. In some cases, they may order a voiding cystourethrogram (VCUG). This test takes pictures of the urinary tract and bladder while you’re urinating. It shows whether you have any problems in this area.

How is a urachal remnant treated?

Treatment for a urachal remnant depends on the type and symptoms you’re experiencing. If you have an infection, your healthcare provider may first prescribe antibiotics.

If you have a urachal cyst, the provider may drain it using a needle. However, because draining isn’t a permanent solution, symptoms can return.

Treatment may include surgery to remove the urachal remnant. But this decision depends on the person’s age. Young children may not need surgery. Your child’s provider will discuss the best treatment options that consider their long-term health and well-being.

What does surgery for a urachal remnant involve?

When surgery is appropriate, healthcare providers remove the remnant using open or laparoscopic techniques. In laparoscopic surgery, the surgeon makes smaller incisions, typically resulting in:

• Less pain.
• Less scarring.
• Shorter recovery.
• Quicker return to daily activities.

How can I prevent a urachal remnant?

A urachal remnant happens during fetal development. There’s no way to prevent it.

Are there long-term effects from a urachal remnant?

Sometimes, children and adults with a urachal remnant develop urachal abnormalities, such as infections.

Having a urachal remnant also increases your risk for developing a type of bladder cancer called urachal cancer. This cancer is rare but aggressive.

Can a urachal remnant return after treatment?

If the urachal remnant is completely surgically removed, you shouldn’t have any complications or returning symptoms.

When should I see a healthcare provider?

If you or your child is experiencing symptoms, such as lower belly pain, discomfort during urination and urinary tract infections, see a healthcare provider. They may recommend an ultrasound, which can reveal a urachal remnant.

A note from Cleveland Clinic

A urachal remnant occurs when the tube between a fetus’s bladder and belly button doesn’t seal as it should. In some cases, a urachal remnant can cause complications, such as urinary tract infections and a rare type of bladder cancer. Surgically removing the remnant prevents these potential complications. A healthcare provider can identify the best treatment approach for you or your child.