Understanding Urachal Cyst : Symptoms, Diagnosis, Causes and Risk Factors

The urachal cyst is a rare congenital abnormality that is known to occur during fetal development.

Urachus is a tubular structure that connects the bladder to the umbilicus during fetal development. Mostly the urachus degenerates and becomes the median umbilical ligament after birth, but in some cases, the urachus may stay and lead to the formation of a urachal cyst.

Urachal cyst occurs when the pocket forms in the remnants of the urachus between the bladder and the naval. These are fluid-filled and vary in size.

The urachus connects the bladder of the fetus to the umbilicus during embryonic development. It helps in eliminating waste products from the fetus.

After the birth of the fetus, the urachus degenerates and becomes the fibrous cord known as the median umbilical ligament, which extends from the bladder to the umbilicus. It has no function in adults. However, it can lead to complications such as urachal cysts and sinuses.

Urachal cyst is rare but can be a potentially serious condition as it can lead to a variety of complications.

The urachal cyst can cause abdominal pain, fever, and difficulty urinating. It may get infected and lead to serious complications such as abscess formation or sepsis. There is also a risk of malignant transformation.⁽¹⁾

Due to the complications, diagnosing and treating urachal cysts promptly is very important.

Urachal cysts are small, uncomplicated, and asymptomatic. They can co-occur with infection or other complications.

The symptoms of urachal cyst include:

• Abdominal pain
• Abdominal distension
• Fever
• Pelvic pain
• Cellulitis in the abdominal wall
• Blood in urine
• Painful urination
• Palpable mass in the abdomen
• Cellulitis in the abdomen

The symptoms may vary depending on the presence of other complications. Severe infection, malignancy, or other complications can lead to the occurrence of additional symptoms:

• Diarrhea
• Vomiting
• Peritonitis
• Abdominal discoloration
• Constipation

Urachal cyst mimics a few conditions such as:⁽²⁾

• Urinary tract infection
• Omphalitis
• Strangulated umbilical hernia
• Cellulitis
• Appendicitis without rupture
• Pelvic inflammatory disease
• Inflammatory bowel disease
• Intra-abdominal umbilical hernia

There are several diagnostic tests that can be helpful in diagnosing urachal cysts:

• Ultrasound uses high-frequency waves to create images of the inside of the body. This helps in visualizing the urachal cyst and determining its size, shape, and location.
• CT scan uses x-ray and computer technology to create detailed images of the body and help in identifying the presence of a urachal cyst. It also provides information about its location and size.
• Magnetic resonance imaging uses magnetic and radio waves to create detailed images of the body. It helps in visualizing the urachal cyst and provides information about its location and size.
• Urine analysis helps rule out other conditions that may be causing similar symptoms such as urinary tract infection.
• Cystoscopy involves inserting a thin flexible tube with a camera into the bladder and examining the urachus and the bladder.

The doctor helps in determining which test is appropriate based on the symptoms of an individual and the medical history.

If the symptoms of a urachal cyst persist, it may indicate an underlying condition. If left untreated urachal cysts can complicated and lead to infection, rupture, and even cancer.

Seeking medical attention can help in diagnosing the condition and getting appropriate treatment. This can be helpful in recovering. Ignoring though may complicate the condition and lead to irreversible damage.

Also, some of the symptoms of a urachal cyst may be present in other conditions as well. A doctor can provide an appropriate diagnosis and plan out an appropriate treatment.

Seeking medical attention for any disease is essential for maintaining good health and preventing potential complications.

The exact cause of the urachal cyst and urachal anomalies is not known. However, there are a few factors that may lead to the development of a urachal cyst.

• Congenital Abnormality: It is the failure of the urachal to close properly. It is often present at birth and is believed that genetic predisposition and congenital anomaly may contribute to it.
• Infection: Infection can lead to inflammation and the formation of the cyst.
• Trauma: Trauma to the lower abdomen and pelvis can cause damage to the urachus and lead to the formation of a urachal cyst.
• Tumor: A tumor may develop in the urachus and lead to the formation of a cyst.

There are also a few risk factors that may increase the likelihood of the occurrence of a urachal cyst.

• A urachal cyst is more common in male gender⁽³⁾
• It is mostly diagnosed in people between 20-50 years of age
• A genetic predisposition to a congenital anomaly may increase the risk of occurrence of a urachal cyst.
• People with a history of bladder cancer have an increased risk of developing urachal cysts.
• Smoking is also associated with increasing the likelihood of developing a urachal cyst.
• Immune system disorders such as HIV and AIDS or people undergoing chemotherapy also increase the risk of developing a urachal cyst.

The treatment options depend on the status of the cyst and rupture and peritonitis. The treatment of urachal cyst may include:⁽³⁾

• Use of antibiotics
• Drainage of the cyst
• Surgical removal of the cyst

It is important to completely remove the remnants of the urachal cyst during surgery. Just draining the urachal cyst with a needle may lead to recurrence which is seen occurring in one-third of the patients.

The surgery is done laparoscopically, robotically, or open surgery is performed.

Oral antibiotics are given to the patient before the removal of the cyst.

In case of any complication, additional treatment is given.

Surgical removal of the urachal cyst is the primary treatment method for the urachal cyst that are symptomatic.⁽⁴⁾

The traditional approach involves removing the urachal remanent via midline laparotomy and the infra umbilical incision. The laparoscopic approach is the minimally invasive approach with cosmetic results and a faster recovery.

Sometimes the bladder is excised for better results.

Surgery removes the urachal cyst completely and it is important as it prevents the recurrence and malignant transformation.

Lifestyle changes cannot cure urachal cysts, but can surely be helpful in managing the cyst and preventing complications. These include:

• Drinking plenty of water helps flush out toxins from the bladder and reduce the chances of contracting an infection.
• Avoiding bladder irritants such as caffeine, alcohol, citrus and spicy foods, and carbonated drinks.
• Practicing good hygiene to keep the area around the urachal cyst clean and dry to help prevent infection.
• Exercising regularly to help improve overall health and reduce the symptoms of urachal cyst.
• Stress worsens symptoms of many health conditions. Managing stress can help in managing the symptoms of the urachal cyst as well.

Mostly urachal cysts are asymptomatic and require no treatment. But there are a few compactions related that everyone needs to know about.

• Infection: If bacteria enter the urachal cyst, it can cause infection. On getting infected it may lead to fever, pain, redness, and swelling around the cyst.
• Rupture: Rupture of a urachal cyst may lead to severe pain leading to peritonitis, which is a serious infection of the lining of the intestinal cavity.
• Obstruction: If a urachal cyst is large, it can obstruct the bladder and cause difficulty in urinating. It may also cause urinary retention in some people.
• Malignancy: The urachal cyst may sometimes convert into a malignant tumor. This may lead to blood in the urine, abdominal pain, and a lump or mass in the lower abdomen.

There are a few preventive measures that can be helpful in preventing the occurrence of a urachal cyst. These include:

• Maintaining Good Hygiene: This involves keeping the area around the cyst dry and clean to prevent infections. Wearing tight clothing around the area should also be avoided.
• Staying Hydrated: It can be helpful in flushing out toxins from the bladder and reducing the risk of infection.
• Practicing Safe Sex: This can help in reducing the risk of sexually transmitted diseases that can lead to bladder infection as well. This can further complicate the urachal cyst.
• Manage Chronic Conditions: Health conditions such as diabetes and kidney diseases can increase the risk of complications. Therefore, working with a healthcare professional to work on these conditions can help in reducing the risk of complications.

The urachal cyst is not a preventable condition but surely following the prevention measures it can be managed and the complications can be prevented.

A urachal cyst occurs when a sac is formed in the abdomen that results from a congenital anomaly involving a urachal cyst.

Mostly urachal cysts may not require any treatment, but they can lead to complications including rupture, obstruction, or malignancy.

Treatment of a urachal cyst may involve surgical removal of the cyst and in some cases, antibiotics are given to treat the condition.

Lifestyle changes can also be helpful in managing the condition and preventing complications.

Anyone with the condition, or even if experiencing similar symptoms should consult a healthcare professional and receive a proper diagnosis and treatment.