An umbilical cyst or urachal cyst, especially when infected can cause symptoms such as pain in the abdomen, pain during urination, UTI infections and even visible belly button discharge in both adults and babies. Below is further information on surgery, ultrasounds, surgery treatment for belly button urachal cyst and much more. Note: This article is simplified and is intended for laymen and not surgeons or medical students.
What is a urachal cyst?
A urachal cyst is a remnant cyst that forms between the umbilicus and the bladder. Its formation occurs during the development of an embryo. Sometimes, it is called a sinus remnant that appears as a pale yellow mass in the area in the abdomen and the pelvis, also called the extraperitoneal space. CT scans and ultrasound are usually able to reveal the problem before treatment such as surgery or excision are done.
How does a urachal cyst form?
Urachal abnormalities develop after birth. Before then, there is need for a fetus to excrete its waste via the mother’s organs. According to Urology Health (see references at the end), there’s a connection between the bladder and the belly button. This connection is what is called the urachus.
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Urachal cyst symptoms
What are the symptoms of urachal cyst? What symptoms will you notice with a remnant infected urachal cyst in adults and newborns? Normally, the remnant cyst is located between the top of the bladder of an adult and the belly button.
Therefore, most symptoms of the umbilical urachus will be found in this space. These may differ slightly in adults and in newborns or babies at a younger age.
Urachal cyst in adults – signs and symptoms
According to a case study report published on NCBI (Hawaii Med J. 2010 Feb; 69(2): 35–36), statistics related to adult umbilical urachal show that it is a rare occurrence in adults compared to newborns. Urachal cysts are extremely rare and even more uncommon in adults, as it is usually diagnosed in children.” [Source – NCBI].
The journal also notes that adults with the following symptoms should be diagnosed for urachal cysts so as not to miss the actual problem.
- Lower abdominal pain even though it is possible for abscesses to present similar symptoms.
- Feeling of a lump in the abdomen, which can also present as a rare occurrence.
- Pain during urination.
- A smelly belly button, sometimes with a discharge in the umbilical or a recurrent moistness in the area.
Umbilical cyst in newborns and its signs
In newborns, a few signs may exhibit differently compared to adults. Before the umbilical heals completely, it can be difficult to identify the problem in neonates. The following are some of the signs and symptoms of urachal cyst in newborns.
- Persistent umbilical wetness which can keep growing into a slightly viscous discharge.
- Belly button discharge or drainage. The Urology care foundation points out that about 65 percent of all urachal cyst problems occur as a sinus drainage at the belly button.
- Urinary tract infections
- Presence of a lump in the abdomen that can be felt.
- Babies may also have persistent fever that accompanies these other symptoms.
Infected urachal cyst treatment and removal
Some sources indicate that necrotizing fasciitis, also called flesh-eating bacterial infection can develop as a complication that results from an infected urachal cyst. If treatment is not done in time, a patient can start showing symptoms of the problem on their skin, starting with the area around the belly button.
According to Koo Han Yoo et al writing about treatment of infected umbilical cysts in the Yonsei Medical Journal of June 30, 2006, 47(3): 423–427, umbilical urachus infections are treated through a two-stage procedure.
In the procedure, a surgeon starts with an initial incision and then drains the infected cyst. The second step includes elective excision. However, recent developments in the medical world have made it possible for a one-step procedure to be carried out to get rid of an infected belly button cyst. This one involves the excision of the growth or cyst and treating it with improved antibiotics.
Laparoscopic excision to treat recurrent urachal cyst infections
Saad A Shebrain, MD and other doctors of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) have published a report on the laparoscopic diagnosis and excision of urachal cysts that present anomalities, ruptures that happen to be recurrent in patients.
Raptured and infected tumors and cysts in the abdomen can be surgically removed and treated laparoscopically to reduce the recovery time after surgery. According to eMedicine Health’s definition, laparoscopy is “a way of performing surgery…” The excision technique involves making smaller incisions and inserting a camera instead of making larger incisions to reduce tissue damage. [Source: eMedicine Health – Laparoscopy].
Urachal cyst ultrasound, pictures or images
Both prenatal ultrasounds and similar diagnosis in adults can reveal the existence of tumors and growths in the abdomen. The University of California San Francisco notes that urachal abnormalities such as urachal cysts are majorly asymptomatic and are only detected when ultrasound is performed on a patient for reasons other than the symptoms indicated above.
Other tests, however might be required, especially a sonogram test which can be more effective for both urachal sinus and patent urachus. In cases of a urinary tract infection that occurs as a result of the cyst, a voiding cystourethrogram test may be performed to check if the patient’s bladder drains properly.
What does a urachal cyst look like? I have included a few images here. The pictures here will help you understand how it appears on ultrasound images or displays. In most cases, asymptomatic urachal abnormalities may not be suspected especially where there is no draining sinus in the abdomen.
However, MRI scans and pelvic CT scans may show something that looks like a “fluid-filled, enclosed lump in the location of the urachus.”
Different types of urachal cysts and abnormalities
Under examination, four different types of urachal abnormalities that may occur in adults, newborns and when pregnant. These include patent umbilical cysts, urachal sinus, diverticulum and a normal umbilical urachal cyst.
- Diverticulum occurs closest to the bladder where the urachus failed to seal and caused a blind ending tract leading from the bladder to the urachus. For this one, a UTI is very common.
- Patent urachus is when there is a connection between the bladder and the umbilicus due to failure of the urachus to seal. In this case, a certain amount of urine can be seen leaking from the belly button.
- Urachal sinus commonly presents with abdominal pain because of the failure of the urachus to seal off close to the ambilicus or navel. Navel infections may be a common problem associated with this type.
A persistent urachus is a common complication, statistics showing that it happens in about a third of all patients with the problem. But what causes a persistent urachal umbilical cyst on the urachus? Non-conclusive treatment is a major cause of such complications.
A urachal cyst can grow back and enlarge if the initial treatment was a simple drainage or needle burst. The persistence or recurrence is as a result of the linings of the structure remaining in place after treatment. Infections and further growth may happen because about 80 percent of the infected structures are populated by a bacterium called staphylococcus aureus.
Can a urachal cyst be cancerous
What is the risk of cancer on bladder or belly button if I have a urachal abnormality? The National Center for Advancing Translational Sciences answers that urachal cancer can develop from a cyst. However, this is a rare occurrence as shown by a certain study.
In children, urachal cancer is very rare since the NIH study showed that there were no cases in children, but 25 percent of adults with urachal cysts were diagnosed with urachal cancer. The risk factor depends on how long it will take before the cyst is removed. The longer it takes, the more likely it is to turn from a benign growth to a cancerous one.
Are urachal abnormalities genetic or hereditary?
There’s no evidence that urachal abdominal abnormalities are hereditary. If they occur or have occurred in your bloodline, it is likely to be a mere coincidence. Most men and women who are healthy may not be aware that they have the cysts until a few of the symptoms start showing. Even so, it does not mean that they inherited the problem from their parents or genetic line.
While infection is the most common complication that occurs with these cysts, calcification of urachal cysts is also reported in the findings of RadioGraphics on the Urachal Remnant Diseases. The same journal also warns that calcification is an almost-diagnostic of urachal carcinoma, pointing to the development of cancer in patients with the problem.
References and Sources
- DermNet NZ: Urachal Cyst Pathology and Histology