Urachal cyst. Current status

Objective: We report one case of urachus diverticulum. It is very rare in adults so that the level of diagnostic suspicion is low.

Methods: 50-year-old male without history of urologic diseases who presented with recurrent urinary tract infections over a two-year period. There were not findings on physical examination. Abdominal ultrasound showed a 3 x 2 cm cystic image with internal echoes on the bladder dome. CT scan confirmed the cystic lesion which thickened the bladder wall at the dome. The patient underwent surgery for the excision of a suspected urachal cyst.

Conclusions: In order of frequency, the 4 types of urachal congenital abnormalities are: permeable urachus (50%), urachal cyst (30%), urachal sinus (15%), and urachal diverticulum (5%). The indication of surgery comes from the possibility of infection and malignant transformation; the cyst should be excised with a bladder dome cuff due to the risk of existence of urachal remnants at that level and their potential to degenerate to adenocarcinoma.