The infected urachal cyst: Primary excision versus a staged approach

Purpose: We compared outcomes following single or 2-stage repair of infected urachal cysts in the pediatric population. Materials and Methods: We reviewed the records of 17 patients 1 day to 14 years old (median age 22 months) with a urachal cyst. Immediate cyst excision was performed in 6 patients without infection, while those with an abscess underwent single or 2-stage repair. Results: Median postoperative hospital stay for the urachal abscess group was 14 and 11.5 days for single and 8-stage procedures, respectively. After immediate excision postoperative complications developed in each case, although none occurred with a 2-stage approach. Conclusions: In the absence of infection, urachal cyst excision affords the most benign postoperative course. However, when infection is present, perioperative drainage with subsequent total excision, including a cuff of bladder, may offer the most effective surgical option.