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Pediatric Urachal Anomalies: Monocentric Experience and Mini-Review of Literature

Matthias Nissen1, Phillip Rogge1, Volker Sander1

  • 1Department of Pediatric Surgery, Marien Hospital Witten, St. Elisabeth Group, Ruhr-University of Bochum, Marienplatz 2, D-58452 Witten, Germany.

Children (Basel, Switzerland)
|January 21, 2022
PubMed

Insights

Infants under one year old with urachal anomalies (UA) experience fewer complications, suggesting non-surgical management may be viable. Further research is needed to confirm if watchful waiting for spontaneous urachal obliteration is a safe alternative to surgery.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Developmental Biology

Background:

  • Urachal anomalies (UA) are typically managed surgically.
  • Emerging evidence suggests spontaneous resolution of UA may occur within the first year of life.
  • This study investigates age-specific patterns in symptomatic UA to support non-surgical approaches.

Purpose of the Study:

  • To identify age-specific patterns in symptoms and outcomes of surgically treated urachal anomalies.
  • To evaluate if findings support the potential for non-surgical management of urachal anomalies.
  • To analyze the relationship between age and complication rates in pediatric urachal anomalies.

Main Methods:

  • Retrospective review of 52 children (<17 years) with symptomatic UA treated surgically (2006-2017).
  • Data stratified by age: <1 year (n=35) vs. >1 year (n=17).
  • Analysis of complicated (abscess, peritonitis) vs. non-complicated courses.

Main Results:

  • Children <1 year old constituted the majority (67%) and had lower complication rates.
  • Complicated surgical courses occurred exclusively in patients >1 year old (p=0.003).
  • Abdominal pain and leukocytosis were significantly associated with complicated courses in older children.

Conclusions:

  • Symptomatic urachal anomalies exhibit an age-dependent complication pattern, with lower rates in infants <1 year.
  • These findings suggest that non-surgical management, including watchful waiting, may be a viable option for younger infants.
  • Larger studies are warranted to confirm the safety and efficacy of non-surgical management for urachal anomalies.
Abstract

Keywords:
abscess formationcomplicationconservative treatmentpediatricperitonitisurachal anomalies

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