Urachus

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Urachus
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Vertical section of bladder, penis, and urethra. Urachus is seen at top
Illu quiz bladder 01.jpg
Urachus is #1
Identifiers
MeSH D014497
Anatomical terminology

The urachus is a fibrous remnant of the allantois, a canal that drains the urinary bladder of the fetus that joins and runs within the umbilical cord. [1] The fibrous remnant lies in the space of Retzius, between the transverse fascia anteriorly and the peritoneum posteriorly.

Contents

Development

The part of the urogenital sinus related to the bladder and urethra absorbs the ends of the Wolffian ducts and the associated ends of the renal diverticula. This gives rise to the trigone of the bladder and part of the prostatic urethra.

The remainder of this part of the urogenital sinus forms the body of the bladder and part of the prostatic urethra. The apex of the bladder stretches and is connected to the umbilicus as a narrow canal. This canal is initially open, but later closes as the urachus goes on to definitively form the median umbilical ligament.

Clinical significance

Failure of the inside of the urachus to be filled in leaves the urachus open. The telltale sign is leakage of urine through the umbilicus. This is often managed surgically. There are four anatomical causes:

The urachus is also subject to neoplasia. Urachal adenocarcinoma is histologically similar to adenocarcinoma of the bowel. Rarely, urachus carcinomas can metastasise to other regions of the body, including pelvic bones and the lung. [4]

One urachal mass has been reported that was found to be a manifestation of IgG4-related disease. [5]

Additional images

Related Research Articles

<span class="mw-page-title-main">Urethra</span> Tube that connects the urinary bladder to the external urethral orifice

The urethra is a tube that connects the urinary bladder to the urinary meatus for the removal of urine from the body of both female and male mammals. In female humans and other primates, the urethra connects to the urinary meatus above the vagina.

<span class="mw-page-title-main">Bladder</span> Organ in vertebrates that collects and stores urine from the kidneys before disposal

The bladder is a hollow organ in humans and other vertebrates that stores urine from the kidneys before disposal by urination. In humans, the bladder is a distensible organ that sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra. The typical adult human bladder will hold between 300 and 500 ml before the urge to empty occurs, but can hold considerably more.

<span class="mw-page-title-main">Prostate</span> Gland of the male reproductive system in most mammals

The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in gross anatomy as consisting of lobes and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue, as well as connective tissue.

<span class="mw-page-title-main">Navel</span> Scarred area on the abdomen after detachment of the umbilical cord

The navel is a protruding, flat, or hollowed area on the abdomen at the attachment site of the umbilical cord. All placental mammals have a navel, although it is generally more conspicuous in humans.

<span class="mw-page-title-main">Seminal vesicles</span> Pair of simple tubular glands posteroinferior to the urinary bladder of male mammals

The seminal vesicles are a pair of convoluted tubular accessory glands that lie behind the urinary bladder of male mammals. They secrete fluid that partly composes the semen.

<span class="mw-page-title-main">Urogenital sinus</span> A part of the human body only present in the development of the urinary and reproductive organs

The urogenital sinus is a part of the human body only present in the development of the urinary and reproductive organs. It is the ventral part of the cloaca, formed after the cloaca separates from the anal canal during the fourth to seventh weeks of development.

<span class="mw-page-title-main">Meckel's diverticulum</span> Medical condition

A Meckel's diverticulum, a true congenital diverticulum, is a slight bulge in the small intestine present at birth and a vestigial remnant of the vitelline duct. It is the most common malformation of the gastrointestinal tract and is present in approximately 2% of the population, with males more frequently experiencing symptoms.

<span class="mw-page-title-main">Allantois</span> Embryonic structure

The allantois is a hollow sac-like structure filled with clear fluid that forms part of a developing amniote's conceptus. It helps the embryo exchange gases and handle liquid waste.

The development of the urinary system begins during prenatal development, and relates to the development of the urogenital system – both the organs of the urinary system and the sex organs of the reproductive system. The development continues as a part of sexual differentiation.

<span class="mw-page-title-main">Male reproductive system</span> Reproductive system of the human male

The male reproductive system consists of a number of sex organs that play a role in the process of human reproduction. These organs are located on the outside of the body, and within the pelvis.

<span class="mw-page-title-main">External sphincter muscle of male urethra</span>

The external sphincter muscle of male urethra, also sphincter urethrae membranaceae, sphincter urethrae externus, surrounds the whole length of the membranous urethra, and is enclosed in the fascia of the urogenital diaphragm.

<span class="mw-page-title-main">Median umbilical ligament</span> Structure in human anatomy

In human anatomy, the median umbilical ligament is an unpaired midline ligamentous structure upon the lower inner surface of the anterior abdominal wall. It is covered by the median umbilical fold.

A urachal cyst is a sinus remaining from the allantois during embryogenesis. It is a cyst which occurs in the remnants between the umbilicus and bladder. This is a type of cyst occurring in a persistent portion of the urachus, presenting as an extraperitoneal mass in the umbilical region. It is characterized by abdominal pain, and fever if infected. It may rupture, leading to peritonitis, or it may drain through the umbilicus. Urachal cysts are usually silent clinically until infection, calculi or adenocarcinoma develop.

The development of the reproductive system is the part of embryonic growth that results in the sex organs and contributes to sexual differentiation. Due to its large overlap with development of the urinary system, the two systems are typically described together as the genitourinary system.

<span class="mw-page-title-main">Urethral sphincters</span> Muscles keeping urine in the bladder

The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.

<span class="mw-page-title-main">Urachal cancer</span> Medical condition

Urachal cancer is a very rare type of cancer arising from the urachus or its remnants. The disease might arise from metaplastic glandular epithelium or embryonic epithelial remnants originating from the cloaca region.

<span class="mw-page-title-main">Diphallia</span> Genital medical condition

Diphallia, penile duplication (PD), diphallic terata, or diphallasparatus, is an extremely rare developmental abnormality in which a male is born with two penises. The first reported case was by Johannes Jacob Wecker in 1609. Its occurrence is 1 in 5.5 million boys in the United States.

A urethral diverticulum is a condition where the urethra or the periurethral glands push into the connective tissue layers (fascia) that surround it.

A urachal fistula is a congenital disorder caused by the persistence of the allantois, the structure that connects an embryo's bladder to the yolk sac. Normally, the urachus closes off to become the median umbilical ligament; however, if it remains open, urine can drain from the bladder to an opening by the umbilicus.

Umbilical-urachal sinus is a congenital disorder of the urinary bladder caused by failure of obliteration of proximal or distal part of the allantois, and the presentation of this anomaly is more common in children and rarer in adults.

References

PD-icon.svgThis article incorporates text in the public domain from page 1213 of the 20th edition of Gray's Anatomy (1918)

  1. Larsen, "Human Embryology," 3rd ed., pg. 258
  2. Le, Tao; Bhushan, Vikas; Vasan, Neil (2010). First Aid for the USMLE Step 1: 2010 (20th Anniversary ed.). US: The McGraw-Hill Companies, Inc. pp.  122. ISBN   978-0-07-163340-6.
  3. Guray, Sogut, et al. (2000) Urachal Cyst. Eastern Journal of Medicine 5(2):76-78.
  4. Elser, C; Sweet, J; Cheran, S K; Haider, M A; Jewett, M; Sridhar, S S (February 2012). "A case of metastatic urachal adenocarcinoma treated with several different chemotherapeutic regimens". Can Urol Assoc J. 6 (1): E27–E31. doi:10.5489/cuaj.11109 (inactive 31 January 2024). PMC   3289708 . PMID   22396380.{{cite journal}}: CS1 maint: DOI inactive as of January 2024 (link)
  5. Travis W. Dum; Da Zhang; Eugene K. Lee (2015). "IgG4-Related Disease in a Urachal Tumor". Case Reports in Urology. 2015: 275850. doi: 10.1155/2014/275850 . PMC   4151357 . PMID   25202466. 275850.