What Is a Urachal Remnant?

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer: What Is a Urachal Remnant?

A urachal remnant is a condition in which the fetal tube that drains urine before the urinary system forms fails to seal, leaving an open connection, cyst or sinus between the bladder and navel. It affects approximately 1% of children and is often found only when infection or pain occurs. Surgery is the definitive treatment, with an excellent prognosis.

What the research says

• Some urachal remnants resolve without surgery, and surgery has its own risks. In a review of 103 children with urachal remnants, 15 of 19 observed patients (78.9%) who were re-imaged had a remnant that resolved spontaneously, none of the observed children later needed excision, and complications occurred in 14.7% of those who had surgery (Naiditch et al., Journal of Pediatric Surgery, 2013). [2]

• Laparoscopic removal is a safe option in children. In 5 children (median age 35 months) who had laparoscopic excision from the umbilicus to the bladder dome, all procedures were completed successfully, with no complications and no recurrences at a median follow-up of 16 months (Masuko et al., Journal of Laparoendoscopic & Advanced Surgical Techniques, 2013). [3]

• Surgical outcomes are generally excellent. Among 35 children operated on for urachal remnants, no major complications occurred and no abnormal tissue was found on histology (Heuga et al., Progrès en Urologie, 2015). [4]

Key Takeaways

Understanding Urachal Remnants

During early fetal development, the urachus serves as a vital conduit, allowing urine to exit the fetus's body through the umbilical cord before the bladder and urethra are fully functional. Under normal circumstances, this tube begins to close during the second trimester of pregnancy, eventually transforming into a small, fibrous cord known as the median umbilical ligament. [1]

When this closure process is incomplete, a urachal remnant is formed. This remnant can take several structural forms, depending on which part of the tube remains open. While the exact cause of this developmental failure is unknown, it is a structural occurrence that is not linked to any maternal actions or environmental factors during pregnancy. [1]

The Four Types of Urachal Anomalies

Medical professionals categorize urachal remnants based on their physical structure and how they connect to the surrounding organs.

1. Patent Urachus: A less common form, where the tube remains completely open from the bladder all the way to the belly button. [1]

2. Urachal Cyst: A pocket of trapped fluid and tissue forms within the urachus, not connected to the bladder or the navel.

3. Urachal Sinus: An opening exists at the belly button, but the tube is closed off before it reaches the bladder. [1]

4. Vesicourachal Diverticulum: The least common type, where an opening exists only at the bladder, creating a small pouch. [1]

Symptoms and Potential Complications

In many cases, a urachal remnant is "silent" and causes no symptoms throughout a person's life. However, when symptoms do occur, they are often related to the type of remnant and whether an infection has developed. [1]

Common Signs to Watch For

• Persistent Wetness: Newborns may have a navel that stays damp or leaks urine (common in patent urachus).

• Abdominal Pain: Discomfort or sharp pain in the lower abdomen, particularly during urination. [1]

• Frequent UTIs: Recurring urinary tract infections without another obvious cause. [1]

• Fever and Redness: Signs of an infected urachal cyst or sinus, which may include swelling around the belly button.

Beyond immediate discomfort, a long-term risk associated with untreated urachal remnants is a slightly increased likelihood of developing urachal cancer, a rare but aggressive form of bladder cancer. Surgical removal of the remnant effectively eliminates this risk. [1]

Diagnosis and Imaging

Healthcare providers usually investigate for a urachal remnant when a patient presents with symptoms or if an anomaly is spotted during testing for an unrelated condition. Confirmation requires detailed imaging of the abdominal area.

• Ultrasound: Often the first step to visualize fluid-filled cysts or open channels. [1]

• CT Scan and MRI: Provide high-resolution cross-sectional views to determine the exact type of remnant. [1]

• VCUG (Voiding Cystourethrogram): A specialized X-ray that monitors the urinary system while the bladder is emptying, helping to identify connections to the bladder. [1]

Treatment and Surgical Recovery

The recommended treatment for a urachal remnant depends on the patient's age, the type of anomaly, and the severity of symptoms. If an infection is present, a course of antibiotics is typically the first step to stabilize the area. [1]

Surgical Removal

For symptomatic remnants, surgery is the standard of care. There are two primary approaches:

• Laparoscopy: A minimally invasive technique using small incisions and a camera. This is the preferred method as it results in less pain, minimal scarring, and a significantly faster recovery time.

• Open Surgery: Used in more complex cases, involving a larger incision in the lower abdomen.

Once the remnant is surgically removed, it does not grow back. The prognosis for patients is excellent, with most returning to normal activities shortly after the procedure. [1]

For more information on pediatric health and surgical recovery, visit our infographic templates.

Frequently Asked Questions

Is a urachal remnant common?

It is relatively rare, estimated to affect about 1% of children.

Can adults have a urachal remnant?

Yes, some people are not diagnosed until adulthood when symptoms like pain or infection finally appear.

Does a urachal remnant always need surgery?

Not always. If there are no symptoms and the risk of complications is very low, some doctors may suggest monitoring instead.

What is the main cause of this condition?

The exact cause is unknown; it is a random developmental event that occurs before birth.

Is it more common in boys or girls?

Statistics show that urachal remnants are more frequently diagnosed in males.

Can a urachal remnant cause cancer?

It increases the risk of a rare type of bladder cancer called urachal cancer, which is why removal is often recommended.

How do I know if my baby's belly button is leaking urine?

If the navel area is persistently wet or has a slight urine-like odor even after the umbilical cord stump has fallen off, consult a pediatrician.

What is a patent urachus?

It is a type of remnant where the tube between the bladder and belly button is completely open.

Can a urachal cyst be drained without surgery?

A doctor may use a needle to drain a cyst temporarily if it is infected, but surgery is usually needed for a permanent fix.

Is laparoscopy better than open surgery?

Laparoscopy is generally preferred because it is minimally invasive, leading to less pain and faster healing.

What imaging is best for diagnosis?

Ultrasound is typically the first choice, followed by MRI or CT scans for more detail.

Does the condition affect how I pee?

It can cause painful urination (dysuria) if the remnant is connected to the bladder or if there is an infection.

Can a urachal remnant cause a UTI?

Yes, bacteria can become trapped in the remnant, leading to recurring urinary tract infections.

What is a VCUG test?

A Voiding Cystourethrogram is an X-ray test that looks at the bladder and urethra while you are urinating.

How long is the recovery after surgery?

For laparoscopic surgery, recovery is usually quick, with most patients feeling better within a few days to a week.

Will the remnant come back after surgery?

No, once the tissue is surgically removed, the condition does not recur.

Is a urachal remnant a birth defect?

It is considered a congenital anomaly, meaning it is present at birth due to a developmental variation.

Can it be detected during a prenatal ultrasound?

Sometimes, but many urachal remnants are too small to be seen until after birth.

Does it affect the shape of the belly button?

It can cause redness, swelling, or discharge at the belly button, but it doesn't usually change its basic shape.

What happens if an infected cyst is left untreated?

The infection can spread to the abdominal cavity (peritonitis) or the bloodstream (sepsis), which are medical emergencies.

Is urachal cancer easy to treat?

Urachal cancer is aggressive and often difficult to treat, which is a primary reason doctors recommend removing remnants early.

Can a urachal remnant cause infertility?

No, it affects the urinary system and does not impact reproductive organs or fertility.

What is the median umbilical ligament?

It is the normal, closed-off fibrous cord that the urachus is supposed to become after birth.

Does the condition run in families?

There is currently no strong evidence that urachal remnants are a hereditary or genetic condition.

Can I exercise with a urachal remnant?

If you have no symptoms, exercise is fine. If you have pain or an active infection, you should wait until after treatment.

What is a vesicourachal diverticulum?

It is a type of remnant where only the end near the bladder remains open, forming a small pouch.

Can a urachal remnant be mistaken for a hernia?

Yes, swelling near the navel can sometimes be confused with an umbilical hernia, but imaging can tell them apart.

Does it affect kidney function?

Typically no, the urachus is connected to the bladder, not the kidneys.

Are there non-surgical treatments?

Antibiotics can treat infections, but surgery is the only way to remove the structural remnant itself.

What is a urachal sinus?

A type of remnant that is open at the belly button but ends blindly before reaching the bladder.

Is the surgery safe for infants?

Yes, pediatric surgeons frequently perform these procedures safely on infants and young children.

Can I get a urachal remnant later in life?

No, you are born with it, but it may not be discovered until you are an adult.

Does it cause blood in the urine?

In some cases, especially if there is an infection or inflammation, hematuria (blood in urine) can occur.

What should I ask my doctor about the surgery?

Ask about the type of surgery (laparoscopic vs. open), the expected recovery time, and any potential risks.

Can a urachal remnant cause a "smelly" belly button?

Yes, discharge from a patent urachus or an infected sinus can cause a noticeable odor.

Is it a type of cancer?

No, the remnant itself is benign (non-cancerous), but it has a small potential to become cancerous later in life.

How rare is urachal cancer?

It is extremely rare, accounting for less than 1% of all bladder cancers.

Does the surgery leave a big scar?

Laparoscopic surgery leaves very small, barely noticeable scars. Open surgery leaves a larger scar in the lower abdomen.

Can I take a bath after surgery?

Your surgeon will provide specific instructions, but usually, you must wait a few days to keep the incisions dry.

Does it affect how much urine the bladder can hold?

A vesicourachal diverticulum might slightly change bladder dynamics, but usually, capacity is not significantly affected.

What is the "urachus"?

It is the embryonic tube that connects the fetal bladder to the allantois (part of the umbilical cord).

Can it cause pain during pregnancy?

If a woman has an undiagnosed urachal remnant, the pressure of a growing uterus might cause new discomfort.

Is the condition related to the umbilical cord?

Yes, the urachus is part of the structures that make up the umbilical cord during early development.

Can a urachal remnant be seen on a CT scan?

Yes, CT scans are very effective at showing the structure and location of urachal anomalies.

Does it cause constipation?

No, it is part of the urinary system and does not typically affect the digestive tract.

What are the signs of a post-operative infection?

Redness, increasing pain, swelling, or discharge at the incision site, along with a fever.

Can I use an IUD with this condition?

Yes, a urachal remnant does not affect the uterus or the placement of an intrauterine device.

Is there a specific age for surgery?

Many surgeons prefer to wait until an infant is a few months old unless symptoms are severe or life-threatening.

Does the condition affect blood pressure?

No, it is not related to the cardiovascular system or blood pressure regulation.

What is the most important thing for parents to know?

Most urachal remnants are easily treated with surgery, and the long-term outlook for the child is excellent.

Related Reading

The Urachus: Understanding Fetal Development and Urachal Remnants explains how the urachus forms before birth and normally closes.

What is an Umbilical Granuloma? explains a common belly button growth in newborns that can look similar.

Umbilical Hernia in Babies and Adults: When It Closes on Its Own and When Surgery Is Needed explains a bulge near the belly button and when it needs repair.

Abdominal Ultrasound: Why It's Done, How to Prepare, What to Expect and Results describes the imaging test often used to find urachal remnants.

Sources

1. Cleveland Clinic. Urachal remnant: symptoms, diagnosis & removal. Cleveland Clinic. Last updated January 12, 2026. https://my.clevelandclinic.org/health/diseases/24223-urachal-remnant

2. Naiditch JA, Radhakrishnan J, Chin AC. Current diagnosis and management of urachal remnants. Journal of Pediatric Surgery. 2013;48(10):2148-2152. PMID 24094971. https://doi.org/10.1016/j.jpedsurg.2013.02.069

3. Masuko T, Uchida H, Kawashima H, et al. Laparoscopic excision of urachal remnants is a safe and effective alternative to open surgery in children. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A. 2013;23(12):1016-1019. PMID 24073840. https://doi.org/10.1089/lap.2013.0127

4. Heuga B, Mouttalib S, Bouali O, et al. Management of urachal remnants in children: is surgical excision mandatory? (article in French). Progrès en Urologie. 2015;25(10):603-606. PMID 26094100. https://doi.org/10.1016/j.purol.2015.05.004

Disclaimer

This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment.