title: Urachal anomalies in children: surgical or conservative treatment?
abstract: OBJECTIVE
  To shed light on the current controversy regarding the best treatment option for managing urachal anomalies in children.
  
  
  METHODS
  A retrospective follow-up of a case series comprising 13 children who were diagnosed with urachal anomalies was performed. All cases were diagnosed between 2000 and 2011 and followed up at the Pediatric Urology Unit of San Cecilio University Hospital in Granada (Spain). Information about the baseline and follow-up variables was collected from clinical records.
  
  
  RESULTS
  Nine of the 13 patients were symptomatic (6 patients with urachal cysts and 3 patients with urachal persistency). Conservative management was originally used in all but one case. During follow-up, reinfection appeared in two cases, and these patients were treated surgically. Spontaneous resolution was achieved in eight cases (61.5%). Two children with persistent urachal cysts are still being followed (4 and 6 years after the diagnosis), although ultrasound monitoring reveals a gradual reduction in the size of the cysts. The median time between diagnosis and resolution was 16.5 months.
  
  
  CONCLUSIONS
  With the exception of cases in which there is a clear indication for surgery (i.e. reinfection), a conservative approach based on regular monitoring may be useful.
authors: Unit of Pediatric Urology, Department of Urology, San Cecilio University Hospital, Granada, Spain. Electronic address: mnogueras@telefonica.net.
authors: Mercedes
authors: M
authors: Nogueras-Ocaña
authors: Department of Pediatrics, San Cecilio University Hospital, Granada, Spain.
authors: Rocío
authors: R
authors: Rodríguez-Belmonte
authors: Department of Pediatrics, San Cecilio University Hospital, Granada, Spain.
authors: José
authors: J
authors: Uberos-Fernández
authors: Unit of Pediatric Urology, Department of Urology, San Cecilio University Hospital, Granada, Spain.
authors: Antonio
authors: A
authors: Jiménez-Pacheco
authors: Unit of Pediatric Urology, Department of Urology, San Cecilio University Hospital, Granada, Spain.
authors: Sergio
authors: S
authors: Merino-Salas
authors: Unit of Pediatric Urology, Department of Urology, San Cecilio University Hospital, Granada, Spain.
authors: Armando
authors: A
authors: Zuluaga-Gómez
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D014496:Urachal Cyst / Q000000981:diagnostic imaging / Q000628:therapy*; D014497:Urachus / Q000002:abnormalities*
keywords: Children; Infection; Urachal anomalies; Urachal cyst