Conservative Management Versus Complete Excision for Pediatric Urachal Remnants: A Retrospective Comparative Study
Jing Xiong1, Zhiru Wang1, Hao Shi1
1Department of General Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, China.
Journal of Pediatric Surgery
|July 16, 2026
Summary
Conservative management of urachal remnants (URs) may prolong treatment, while complete surgical excision offers single-course resolution at higher cost. Prompt surgery is recommended for recurrent URs.
Area of Science:
- Pediatric Surgery
- Urology
- Medical Management
Background:
- Urachal remnants (URs) management is debated.
- Evidence comparing conservative therapy and surgical excision for URs is needed.
Purpose of the Study:
- To compare conservative therapy with complete surgical excision for urachal remnants.
- To provide evidence for urachal remnant treatment decision-making.
Main Methods:
- Retrospective review of 89 patients with urachal remnants (URs) treated at Shanghai Children's Hospital (June 2014 - June 2025).
- Analysis of demographic and clinical data for conservative management (CM) and complete excision (CE) groups.
Main Results:
- The CE group included younger patients (median age 0.2 years) compared to the CM group (median age 2.3 years).
- Umbilical discharge was the most common symptom; urachal cysts predominated in CM, patent urachus in CE.
- CM had longer hospitalization (P=0.015) and readmissions (16/52), while CE had higher costs (P=0.019) and fewer complications.
Conclusions:
- Conservative treatment for urachal remnants may lead to a longer treatment duration.
- Complete surgical excision offers single-treatment resolution but incurs higher costs.
- Prompt surgery is advisable for recurrent or emergent urachal remnants.