Incidental finding of unusually located urachal remnant and its implications for prostatectomy – case report

Urachal anomalies are rare congenital malformations resulting from the failure of the caudal portion of the allantois to obliterate, which, by stretching and narrowing, forms the urachus. Such pathologies may be both symptomatic and asymptomatic if they become infected or undergo malignant transformation. In this paper, we report an unusual form of a urachal remnant in a 68-year-old Caucasian male, detected incidentally during open, radical, non-nerve-sparing, retropubic prostatectomy, performed from the suprapubic access point. The structure attached to the anterior wall of the urinary bladder appeared to connect to a cutaneous sinus at the dorsum of the penis and posed a challenge for dissection of the retropubic space of Retzius. We discuss how surgeons could benefit from the knowledge that such structures are able to appear.