Urachus persistent is a condition where the fetal urinary canal or urethra remains after delivery. This condition can be dangerous for the baby, Mom.
How do you know if the urachus exists or not after delivery, and how to handle it? Check out the explanation below, Mom.
Persistent Urachus Is A Condition That Can Be Harmful To The Baby
The persistent urachus is a remnant of a canal – a thick tube or cord that contains blood vessels calledallantois– between the bladder and the umbilicus (navel) in the fetus’ body during the first trimester of pregnancy, which functions to channel the fetus’ urine.
PagesUniversity of California San Franciscoexplains, the urachus channel generally closes and disappears at 12 weeks of pregnancy, then all that remains is a small fibrous cord between the bladder and the umbilicus called the median umbilical ligament.
Sometimes, quotingUrology Health, this channel remains after birth. The urachus has no use after birth, and if this organ remains, it can actually cause health problems in the baby. These problems are calledurachal abnormalitiesor urachal abnormalities.
Types of Urachus Disorders
Urachal disorders occur when there is an abnormality with the closure of the channel during fetal development. There are at least 4 types of urachal disorders. Namely:
- Urachal Cyst. Occurs when part of the urachus does not close, but there is no connection between the bladder and the umbilicus. Often there are no symptoms and are only detected when an ultrasound is performed for another reason. Sometimes a urachal cyst can become infected and can cause abdominal pain or can start to leak cloudy or bloody fluid from the umbilicus. This problem usually occurs in children aged 2-4 years.
- Patent Urachus. Occurs when the urachus does not close – either due to a hole or sinus – and there is a connection between the bladder and the umbilicus. This condition can cause some urine to leak through the umbilicus.
- Urachal Sinus. Occurs when the urachus does not close close to the umbilicus and leads to a blind channel from the umbilicus into the urachus called the sinus. It can be asymptomatic or present with infection accompanied by abdominal pain and drainage of fluid.
- Diverticulum . Occurs when the urachus does not close close to the bladder and leads to a blind channel from the bladder into the urachus called a diverticulum. This can also be asymptomatic or present with a urinary tract infection.
Symptoms or Signs
Because the urachus is found between the navel and the top of the bladder, urachus disease can appear anywhere in that area.
Visible Signs
In newborns and older babies, persistent umbilical drainage or “wetness” can be a sign of a problem. The most common problem in the umbilical cord is a granuloma, which is a red, irritated area caused by the base of the umbilical cord stump not healing properly.
Sometimes the area can become very red, even after the umbilical cord falls off. To overcome this, you can apply a little alcohol or hydrogen peroxide to the area twice a day, usually the granuloma will heal 2-3 days later. If the redness does not go away or gets worse, see a doctor immediately.
Other Signs
A dry or non-wet navel does not mean there is no problem. In fact, about 35 percent of urachus disorders come from a closed or infected urachal cyst. Usually this problem is more common in older children and adults.
Common signs and symptoms of persistent urachus are:
- Lower abdominal pain
- Fever
- A lump in the navel area that can be felt
- Pain when urinating (peeing)
- Urinary tract infection (UTI)
- There is blood in the urine (hematuria)
Causes of Persistent Urachus
Persistent urachus is a rare condition. It usually occurs in infants or children, and is rare in adults. What causes it? It’s not clear why it happens.
This condition also often occurs in the form of lumps or cysts that can become infected because both ends of the duct are closed, while the middle part is open so that fluid collects there.
Babies who experience persistent urachus problems will usually experience lower abdominal pain, fever, pain when urinating, urinary tract infections or blood in the urine.
Launching the page Cleveland Clinic, other causes of persistent urachus problems are blood vessel infections in the urachus or problems with the urinary tract.vitelline, which is between the navel and the small intestine.
Sometimes health problems such as appendicitis or ovarian cysts can also be a sign of urachal problems.
Frequency of Occurrence
How common is this urachus abnormality in babies? The frequency of occurrence varies, depending on the type of problem.
The incidence of urachal anomalies is considered rare. Asymptomatic urachal remnants may be present in up to 2 percent of the general population according to autopsy studies, and even then they are rarely symptomatic. Like urachal cysts, they are asymptomatic unless infected.
Of all types of urachus, urachal cysts account for 30 percent of all urachal anomalies and are the second most common anomaly after patent urachus (50 percent).
Urachal cysts are found in 1:5000 autopsies and occur more frequently in boys. The prevalence of patent urachus is estimated to be 1 to 2 cases per 100,000 births.
Diagnosis of Persistent Urachus
Urachal disorders are usually diagnosed when there are symptoms such as drainage from the umbilicus, redness around the umbilicus, abdominal pain, or a urinary tract infection. If your doctor sees these signs and symptoms in your child, he or she may perform these tests to help diagnose your child’s condition:
- If the doctor suspects that the fetus has persistent urachus during the physical examination, he or she will perform an ultrasound to look at the internal tissues and organs.
- In some cases, MRI (magnetic resonance imaging) may be necessary. Ultrasound and MRI are noninvasive, painless examination methods that function to take pictures inside your body.
- If your doctor suspects that the wetness near your baby’s belly button is actually urine coming from the bladder, he or she will test the fluid to see if it contains urea or creatinine (both of which are present in urine). If the results are positive, your doctor will perform a sonogram. This is a test in which a small tube is placed through the belly button opening to inject dye into it, as an X-ray area will be taken. If the dye is seen moving from the belly button to the top of the bladder, it is a sign that your baby has a urachal sinus problem.
- Voiding Cystourethrogram (VCUG). This test is done if there is a urinary tract infection or to make sure the bladder is draining properly.
Handling
The main reason persistent urachus needs to be treated is to address symptoms such as drainage, irritation, and infection.
If urachal obstruction occurs with infection, the doctor will treat the infection first. The doctor will give antibiotics (eg intravenous antibiotics) and or surgical drainage (if the cause is an infected cyst or poorly draining cavity).
Once the infection is under control, excision of the urachus is usually performed (the umbilicus is not removed). This can be done laparoscopically or through a small incision in the lower abdomen. The patient will stay in the hospital for 1-2 days after surgery.
In some cases, doctors can remove the urachus using robotic surgery, an invasive technique similar to laparoscopic surgery.
After controlling the infection and surgical removal of the urachal abnormality, your baby will hopefully have no more problems with the urachus.
Possible Complications
There is a small risk of local infection of less than 10 percent after urachus removal, but this can usually be treated simply with antibiotics .
Meanwhile, problematic urachal tissue that is not immediately treated can increase the risk of children getting cancer.
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Thus the explanation of the condition of persistent urachus. If your baby… Parents If you experience this, immediately take him to the doctor to get proper treatment.
Republished with permission from theAsianparent Indonesia
