TITLE:
Persistent Urachal Sinus in an Adult Female: Presentation and Surgical Management Strategy
AUTHORS:
Adrien Valère Yongho Mounchili, Maurice Esong Fonji, Frantz Ngalle Epoupa
KEYWORDS:
Urachal Sinus, Adult, Umbilical Discharge, Computed Tomography Urography, Bladder Distention
JOURNAL NAME:
Open Journal of Urology,
Vol.16 No.10,
October
23,
2026
ABSTRACT: Background: Urachal anomalies are rare embryological pathologies resulting from incomplete involution of the allantois. While typically diagnosed in the pediatric population, they remain an infrequent and often misdiagnosed cause of umbilical malady in adults, with an estimated incidence of 1 in 150,000. Among the different anomalies, the urachal sinus is a distinct clinical entity that remains quiescent until triggered by secondary infection. Case Presentation: A 26-year-old female presented with a sub-acute history of persistent, malodorous umbilical discharge and chronic periumbilical pain. Physical examination revealed an inverted umbilicus with mild deep tenderness but no seropurulent discharge. CT scan identified an infra-umbilical sinus tract connected to the bladder dome via a fibrous band. Urine cultures were sterile. A definitive open surgical excision was performed with the bladder retrogradely distended with 250 mL of sterile saline via a transurethral catheter. The sinus tract was excised in its entirety. The postoperative course was uneventful, with complete resolution of symptoms. Conclusion: A high index of clinical suspicion is required for adults presenting with persistent umbilical discharge. CTU is the gold standard for defining the anatomy of the remnant. We recommend the use of intraoperative bladder distention as a simple and effective technical pearl to prevent iatrogenic bladder injury and ensure the total excision of the urachal tissue, thereby minimizing the risk of recurrence and future malignant transformation.