Laparoscopic excision of urachal cysts in elderly men and woman following pregnancy

Abstract

Background and Objective: Persistent urachus rarely presents in the aging male or during pregnancy. The authors report their experience with the laparoscopic excision of urachal cysts in two elderly men with significant co-morbidities and following pregnancy in a 32-year old female. Material and Method: The two male patients (65 and 70 years old, respectively) presented with a lower abdominal mass and umbilical discharge, while persistent urachus was identified incidentally during pregnancy; patients were managed with laparoscopic excision at 4 weeks, 6 weeks, and one year after diagnosis, respectively. Using 3 port accesses, the urachus and medial umbilical ligament were clipped and divided. In 2 cases, specimens were separated from the bladder dome with a bladder cuff. In one patient, an additional port was required to facilitate intracorporeal freehand suturing of the bladder defect. Results: All procedures were completed successfully via laparoscopy. No intraoperative or postoperative complications were reported. Operative time ranged from 120,180 and 160 minutes, respectively; in-hospital convalescence was 1, 7, and 6 days, respectively. Pathological evaluation revealed a benign urachal remnant in each case. Conclusion: Laparoscopic excision of urachal cysts in the aging male or following pregnancy is safe and effective.