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


METHODS
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.


CONCLUSIONS
Laparoscopic excision of urachal cysts in the aging male or following pregnancy is safe and effective.
Permpongkosol
Sompol
S
Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. permpongkosol@gmail.com
Bella
Anthony J
AJ
Suntisevee
Suchaya
S
Leenanupunth
Charoen
C
Stoller
Marshall L
ML
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011247:Pregnancy; D014472:Umbilicus / Q000601:surgery; D014496:Urachal Cyst / Q000601:surgery