Urachal Cyst: What My Experience Taught Me

Last June 2012, I experienced recurring and disturbing pain around my navel area, and a few days later, my navel started giving off clear smelly discharge. I decided to consult a doctor, and I was given a seven-day course of clindamycin. I hoped that the medication would make me feel better, instead, the pain escalated and my navel started giving out yellowish liquid—pus. That alerted me, and I decided to rush myself to the emergency room. The attending doctor checked my navel and requested a whole abdomen ultrasound. I was encouraged to stay overnight so they can examine me closer, but I refused. I was sent home and was given metronidazole and ciprofloxacin since they are uncertain what causes the infection. I was also told to wait revisit them once the result of the ultrasound is released. The result of the ultrasound confirmed her suspicion: I have a urachal cyst.

Urachal cyst is a congenital birth defect characterized by a sinus remaining from the allantois during embryogenesis—that is, there is a small fluid-filled cavity remains between the umbilicus and the bladder. (Allantois is the structure that removes waste during fetal development.) People with urachal cyst may remain asymptomatic until a problem develops—or so in my case, a bacterial infection contracted in the inner area of my umbilicus and tapped the cyst. I was told by my attending physician that it in itself, the urachal cyst is harmless unless it becomes the breeding ground of infection of whatever kind.

Once the urachal cyst is infected, the patient may experience abdominal pain, swelling and/or tenderness, discharge around the umbilicus, and difficulty urinating. An ultrasound examination will reveal the fluid-filled cavity in a location where one should not be. Another serious concern is the risk of rupture. As long as the urachal cyst remains anchored in place, the patient should remain relatively stable, although infections can cause tissue death and complications like organ failure. If the structure breaks open, it can compress other organs and may potentially be fatal if internal bleeding occurs. In cases of rupture, the patient typically reports an acute onset of pain and discomfort, and may go into shock as a result of internal bleeding.

The typical treatment for a urachal cyst is surgery to address the abnormality. In patients with infections, the patient may need to remain on antibiotics to stabilize before the surgery can take place. In cases where neighboring tissue dies as a result of the infection, the surgery will include debridement to take this tissue out so it does not cause problems for the patient.

In my case, I was scheduled for a surgery, but due to financial reasons, it was and is still postponed. I was admitted in the hospital for four days, where I was treated with IV antibiotics (ertapenem sodium) once a day, which costs around ninety-three (93) US dollars per administration. The infection was subdued, and m condition is still under observation (lest I need an emergency surgery); and fortunately, my condition seems to be good.

The reasons for urachal cyst formation remain obscure. There do not appear to be any steps people can take during pregnancy to prevent cysts from growing, and they often appear independent of other fetal abnormalities. In cases where a baby has structural anomalies in the urinary tract, the doctor will conduct an ultrasound to check for problems like urachal cysts and kidney malformations, to rule out any associated complications. A pediatric urologist often takes charge of care for this condition, providing parents with advice and information on how to proceed. If the condition is not diagnosed until adulthood, the patient can see a regular urologist to discuss treatment options.

However, I was told by the doctor that since I am a menopausal baby (my mother conceived me after her menopause) and was born prematurely at seven months, the reason of the birth defect is very obvious. These days, whenever I feel a simple pain near my navel area, I do not hesitate to rush to the doctor and demand to have an ultrasound request. Better safe than sorry, and besides, these steps are covered by our company insurance, while sadly, congenital conditions, such as my urachal cyst, are not covered.

Common Symptoms of Urachal Cyst:

• Lower abdominal pain
• Pain on urination
• Persistent umbilical discharge
• Fever
• UTI (Urinary Tract Infection)
• Lump
• Hematuria