Neha Patil (Editor)

Urachus

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MeSH
  
A16.254.835

Dorlands /Elsevier
  
u_03/12837658

Urachus

The urachus is a fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord. The fibrous remnant lies in the space of Retzius, between the transversalis fascia anteriorly and the peritoneum posteriorly.

Contents

Development

The part of the urogenital sinus related to the bladder and urethra absorbs the ends of the Wolffian ducts and the associated ends of the renal diverticula. This gives rise to the trigone of the bladder and part of the prostatic urethra.

The remainder of this part of the urogenital sinus forms the body of the bladder and part of the prostatic urethra. The apex of the bladder stretches and is connected to the umbilicus as a narrow canal. This canal is initially open, but later closes as the urachus goes on to definitively form the median umbilical ligament.

Clinical significance

Failure of the inside of the urachus to be filled in leaves the urachus open. The telltale sign is leakage of urine through the umbilicus. This is often managed surgically. There are four anatomical causes:

  • Urachal cyst: there is no connection between the bladder and the umbilicus
  • Urachal fistula: there is free communication between the bladder and umbilicus
  • Urachal diverticulum [Vesicourachal diverticulum]: the bladder exhibits outpouching
  • Urachal sinus: the pouch opens toward the umbilicus
  • The urachus is also subject to neoplasia. Urachal adenocarcinoma is histologically similar to adenocarcinoma of the bowel.

    One urachal mass has been reported that was found to be a manifestation of IgG4-related disease.

    References

    Urachus Wikipedia