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Bladder
Congenital anomalies
Urachus / Patent Urachus
Author: Nat Pernick, M.D. (see Authors page)
Revised: 28 February 2010, last major update February 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● 5 cm vestigial structure connecting dome of bladder and umbilicus
● Pathology other than patent urachus (click here) is described separately in the Table of Contents
Terminology
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Epidemiology
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Sites
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Embryology
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● Arises from superior urogenital sinus
● In fetus, connects bladder dome with allantois (embryonic diverticulum of hindgut, vessels are precursors to those in umbilical cord)
● Fragmentation occurs post-partum when bladder descends into pelvis; urachus eventually becomes median umbilical ligament
Clinical features
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● Urachal remnants may be found in midline or posterior bladder wall
● Remnants seen at autopsy in 50% of fetuses, 33% of adults
● Remnants are associated with urachal cysts, sinus, fistula, diverticulum, infections, adenocarcinoma of bladder; also urothelial carcinoma, villous adenoma, squamous cell carcinoma
Prognostic factors
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Case reports
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Treatment
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Clinical images
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Gross description (Macroscopy)
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Gross images
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Micro description (Histopathology)
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● Usually persists as fragmented tubules separated by fibrous cords, but without a desmoplastic tissue response
● Composed of stratified epithelium, columnar epithelium or urothelium
● No goblet cells, no atypia
Micro images
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Dilated urachal remnant
Cytology description
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Cytology images
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Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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Definition
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● Rare – lumen typically closes at week 17 post-conception (Cells Tissues Organs 2009 Nov 17 [Epub ahead of print])
● Leads to urination through umbilicus
● May be associated with infections
Terminology
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● Also called persistent urachus
Case reports
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● Giant umbilical cord edema caused by retrograde micturition through an open patent urachus (Pediatr Dev Pathol 2010 Jan 19 [Epub ahead of print])
Diagrams
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Patent Urachus
End of Bladder > Congenital anomalies > Urachus
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