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Urachal Remnant
January 2002

Q. I have recently been diagnosed with a Urachal Remnant and have been advised to have surgery to remove it. I am 29 and I live in Scotland and have the luxury of medical insurance so I am going private to have it removed.

My consultant has said that it will require a 6-8 inch incision from the umbilicus to the pubic region. Can this procedure not be performed with a laparascope?

Also I have a super pubic tattoo that I do not have time to have lasered off before surgery and if the surgeon performs the operation as intended with the large incision he will cut straight through the tattoo. I will be unable to have it lasered off afterwards and no tattooist will tattoo over scar tissue to disguise it.

Also I have read with interest on the internet that removal of the Urachus in adults often requires abdominoplasty to reconstruct the naval again, is this true? I will feel embarrassed enough with a mauled tattoo. I cannot do anything to hide without having a mutilated naval.

A. The urachus is a tube that connects the bladder to the umbilicus during fetal development and closes before birth. If this closure fails to take place, a urachal cyst or remnant remains. Infection can occur in the remaining tissue, and there is a risk for cancer developing, so surgical removal is usually advised.

Indeed the laparoscope has been successfully used to remove a urachal cyst with good results. You may need to interview a few surgeons to see if this is practical in your case. The use of ultrasound and CT imaging can often determine the extent of the urachal tissue to be treated. And consulting with a dermatologist or plastic surgeon on how to deal with the tattoo is a good idea.

http://www.nlm.nih.gov/medlineplus/ency/article/002993.htm

http://www.ispub.com/journals/IJU/Vol1N1/urachal.html

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