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Clinical features and nonoperative strategy for first-time infected urachal cysts in infants
Baifeng Chen1, Bingliang Li2,3, Wei Wang1
1Department of Urology, Shanxi Medical University Affiliated Children's Hospital, Taiyuan, China.
Insights
Nonoperative management, including antibiotics and drainage, effectively treats infected urachal cysts in infants under 12 months. Most infants achieve complete resolution, with surgery rarely needed and typically indicated within 3 months post-infection control.
Area of Science:
- Pediatric Surgery
- Urology
- Infectious Diseases
Background:
- Infected urachal cysts are a common pediatric surgical condition.
- Nonoperative management is often the initial approach for infected urachal cysts in infants.
Purpose of the Study:
- To evaluate the clinical characteristics and outcomes of nonoperative management for first-time infected urachal cysts in infants up to 12 months old.
- To compare treatment responses between infants ≤6 months and 6-12 months of age.
Main Methods:
- Retrospective analysis of clinical data from infants ≤12 months with first-time infected urachal cysts.
- Nonoperative management included antibiotic therapy and/or ultrasound-guided percutaneous drainage.
- Infants were stratified into ≤6-month and 6-12-month age groups for comparative analysis.
Main Results:
- 49 infants were analyzed; 75.5% presented with abscess formation.
- Complete resolution was achieved in 79.6% of infants.
- The younger group (≤6 months) required significantly more percutaneous drainage (90.9% vs. 62.9%).
- All infants requiring surgery did so within 3 months after infection control.
Conclusions:
- Nonoperative management leads to high rates of complete resolution for infected urachal cysts in infants.
- Age stratification did not significantly impact complete resolution rates but influenced drainage methods.
- While surgical cases clustered within 3 months post-infection control, this timeframe should not be a definitive surgical threshold.
Objectives:
To investigate the clinical characteristics and outcomes of nonoperative management in infants aged ≤12 months with first-time infected urachal cysts, with a focus on comparing treatment responses between the ≤6-month and 6-12-month age groups.
Methods:
A retrospective analysis was conducted on clinical data and follow-up outcomes of infants aged ≤12 months with first-time infected urachal cysts admitted between January 2012 and January 2026. All patients initially received nonoperative management (including antibiotic therapy alone, or antibiotic therapy combined with ultrasound-guided percutaneous drainage). Clinical characteristics and cyst regression were recorded. Patients were stratified by age into the ≤6-month group and the 6-12-month group for comparison. Cyst outcomes were classified into three categories: complete resolution, marked regression (≥50% reduction with residual lesions), and treatment failure (requiring surgery).
Results:
A total of 49 infants were enrolled. Umbilical local manifestations were the most common presenting symptoms (79.6%), and the abscess formation rate was 75.5%. The complete resolution rate was 79.6% (39/49), the marked regression rate was 8.2% (4/49), and the eventual surgical rate was 12.2% (6/49). The complete resolution rates were 77.3% and 81.5% in the ≤6-month and 6-12-month groups, respectively; however, the younger group had a significantly higher rate of percutaneous drainage (90.9% vs. 62.9%, P = 0.024). All infants who required surgery had their surgical indications established within 3 months after infection control.
Conclusions:
In infants (≤12 months of age) with first-time infected urachal cysts, the majority achieve complete cyst resolution after nonoperative management. The observation that all surgical cases clustered within 3 months after infection control warrants attention, but it should not be used as a definitive surgical decision threshold. These conclusions are based on short-term follow-up data; long-term safety requires further confirmation through extended follow-up.
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