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 forms from the distal end of the allantois in the embryo, and develops into a closed cord between the base of the bladder, and the navel. [1] It drains the bladder of the fetus that joins and runs within the umbilical cord. [2] The fibrous remnant lies in the space of Retzius, between the transverse fascia anteriorly and the peritoneum posteriorly. At birth, the urachus develops into the median umbilical ligament. [3] [4]

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. [7]

One urachal mass has been reported that was found to be a manifestation of IgG4-related disease. [8]

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 the tube that connects the urinary bladder to the urinary meatus, through which placental mammals urinate and ejaculate. In non-mammalian vertebrates, the urethra also transports semen but is separate from the urinary tract.

<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. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distensible organ that sits on the pelvic floor. 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

The prostate is 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.

<span class="mw-page-title-main">Seminal vesicles</span> Pair of simple tubular glands

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

<span class="mw-page-title-main">Urogenital sinus</span> Embryological part during the development of the urinary and reproductive organs in mammals

The urogenital sinus is a body part of a human or other placental 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> Birth defect of a bulge in the small intestine

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 one the extraembryonic membranes arising from the yolk sac. It is a hollow sac-like structure filled with clear fluid that forms part of the developing conceptus in an amniote that helps the embryo exchange gases and handle liquid waste. The other extraembryonoic membranes are the yolk sac, the amnion, and the chorion. In mammals these membranes are known as fetal membranes.

<span class="mw-page-title-main">Diverticulum</span> Medical or biological term for an outpouching of a hollow (or a fluid-filled) structure in the body

In medicine or biology, a diverticulum is an outpouching of a hollow structure in the body. Depending upon which layers of the structure are involved, diverticula are described as being either true or false.

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">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">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.

Lower urinary tract symptoms (LUTS) refer to a group of clinical symptoms involving the bladder, urinary sphincter, urethra and, in men, the prostate. The term is more commonly applied to men – over 40% of older men are affected – but lower urinary tract symptoms also affect women. The condition is also termed prostatism in men, but LUTS is preferred.

<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. In contrast to a urachal diverticulum, it is characterised by focal dilatation of the umbilical portion of the remnant urachal tract.

A urachal diverticulum is a congenital disorder caused by the partial persistence of the allantois. The allantois, which later becomes the urachus, connects an embryo's bladder to the yolk sac. Normally, the urachus closes off to become the median umbilical ligament; however, if it does not seal close to the bladder, a blind pouch connected to the bladder remains. This is usually asymptomatic but can lead to recurrent urinary tract infections. If the urachus is wholly patent, urine can drain from the bladder to an opening by the umbilicus, a condition known as urachal fistula.

References

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

  1. "Urachus". www.cancer.gov. 2 February 2011. Retrieved 21 December 2024.
  2. Larsen, "Human Embryology," 3rd ed., pg. 258
  3. Tan C, Simon MA, Dolin N, Gesner L (August 2020). "Incidental vesicourachal diverticulum in a young female". Radiology Case Reports. 15 (8): 1305–1308. doi:10.1016/j.radcr.2020.05.046. PMC   7322240 . PMID   32612730.
  4. Mrad Daly K, Ben Rhouma S, Zaghbib S, Oueslati A, Gharbi M, Nouira Y (September 2019). "Infected urachal cyst in an adult: A case report". Urology Case Reports. 26: 100976. doi:10.1016/j.eucr.2019.100976. PMC   6661533 . PMID   31380223.
  5. 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.
  6. Guray, Sogut, et al. (2000) Urachal Cyst. Eastern Journal of Medicine 5(2):76-78.
  7. 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 1 November 2024). PMC   3289708 . PMID   22396380.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  8. 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.