Pyourachus in spina bifida: case report and review

Area of Science:

• Urology
• Pediatric Surgery
• Developmental Biology

Background:

• The urachus, a remnant of the allantois, typically obliterates after birth.
• Failure of urachal closure leads to various congenital anomalies.
• Urachal anomalies are often associated with bladder outlet obstruction but not previously with spina bifida.

Observation:

• Two adolescent males with spina bifida, neuropathic bladders, and self-catheterization developed urachal abscesses.
• Clinical presentations varied, with one case showing classic umbilical involvement.
• Diagnosis can be challenging due to diverse presentations.

Findings:

• This study identifies a novel association between urachal abscesses and spina bifida.
• The cases involved patients with neuropathic bladders and intermittent self-catheterization.
• Urachal abscesses represent a potential complication in this specific patient demographic.

Implications:

• Urachal anomalies should be included in the differential diagnosis of pelvic masses in patients with spina bifida.
• This finding expands the known spectrum of urachal anomaly associations.
• Increased awareness may improve diagnostic timelines and patient outcomes.