Laparoscopic Excision of Urachal Cysts in Elderly Men and woman Following Pregnancy
Sompol Permpongkosol MD, PhD*, Anthony J Bella MD**, Suchaya Suntisevee BNS*, Charoen Leenanupunth MD*, Marshall L Stoller MD***
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand ** Division of Urology, Department of Surgery, University of Ottawa, Canada *** Department of Urology, University of California-San Francisco, San Francisco, California, USA
Background and Objective : Persistent urachus rarely presents in the aging male or during pregnancy. The
authors report their experience with the laparoscopic excision of urachal cysts in two elderly men with
significant co-morbidities and following pregnancy in a 32-year old female.
Material and Method: The two male patients (65 and 70 years old, respectively) presented with a lower
abdominal mass and umbilical discharge, while persistent urachus was identified incidentally during
pregnancy; patients were managed with laparoscopic excision at 4 weeks, 6 weeks, and one year after
diagnosis, respectively. Using 3 port accesses, the urachus and medial umbilical ligament were clipped and
divided. In 2 cases, specimens were separated from the bladder dome with a bladder cuff. In one patient, an
additional port was required to facilitate intracorporeal freehand suturing of the bladder defect.
Results : All procedures were completed successfully via laparoscopy. No intraoperative or postoperative
complications were reported. Operative time ranged from 120,180 and 160 minutes, respectively; in-hospital
convalescence was 1, 7, and 6 days, respectively. Pathological evaluation revealed a benign urachal remnant
in each case.
Conclusion : Laparoscopic excision of urachal cysts in the aging male or following pregnancy is safe and
effective.
Keywords : Urachal cyst, Remnant, Laparoscopy, Surgery
