Umbilical Urinary Fistula: Symptoms and Post-Surgery Concerns

Umbilical catheter

Dear Dr.
Chen,
Thank you very much for taking the time to answer my questions.
Three years ago, I underwent surgery for a urachus anomaly due to pus discharge from my navel and severe pain.
When pressure was applied to my abdomen, the pain radiated from my navel to the area below the urethra and testicles, which was extremely painful.
After examination, it was determined that my urachus had not fully regressed and was inflamed.
The surgeon informed me that he removed the entire urachus, including the portion attached to the bladder, and sutured several stitches on the bladder.
However, my current issue is that whenever I tighten my abdomen, I feel a strong urge to urinate.
Leaning back causes pain that radiates from my navel down to the urethra and testicles, and I also feel uncomfortable and have the urge to urinate when lying flat.
If I press on my abdomen, I experience pain directly below the navel and on both sides, with pain throughout the urethra.
This sensation has never occurred before and has persisted since the urachus inflammation.
Additionally, I have another issue: my anus is very itchy, and there is some moist discharge (which I suspect may be fecal matter, causing skin irritation and itching).
I wonder if this is related to the previous surgery.
I kindly ask for your assistance in clarifying these concerns.
Thank you very much.
Best wishes for your health and happiness.

Mr. Hong, 20~29 year old female. Ask Date: 2004/01/27

Dr. Chen Xiuyi reply Urology

Hello! In cases of urachal duct infection, surgical treatment typically involves the complete excision of the urachal duct.
During the surgery, if the abdominal cavity is entered, there is a risk of developing intestinal adhesions, which can lead to various complications.
Generally, after suturing the bladder wound, it should not cause lower urinary tract symptoms.
It is advisable to check for any abnormalities in the urine, and it would be best to have the operating surgeon reassess the situation.
As for the itching and discharge around the anus, this is likely unrelated to the surgery, and a consultation with a colorectal surgeon should be sought to check for any anal fistula or anal fissure.
Sincerely, Dr.
Chen Hsiu-Yi, Director of Urology, Taoyuan Hospital, Department of Health, Executive Yuan.

Reply Date: 2004/01/27

More Info

Umbilical urinary fistula, also known as a urachal fistula, is a rare condition that occurs when the urachus, a remnant of fetal development that connects the bladder to the umbilical cord, fails to close properly after birth. This can lead to a connection between the bladder and the umbilicus, resulting in urine leaking from the belly button. Symptoms of this condition can include persistent drainage from the umbilicus, abdominal pain, and urinary symptoms such as urgency or frequency.

In your case, it appears that you underwent surgery to remove the urachal remnant due to inflammation and infection. Post-surgery, it is not uncommon to experience some discomfort or pain in the abdominal area, especially if the surgical site is still healing. The pain radiating from the umbilicus to the urethra and testicular area could be related to nerve irritation or inflammation in the surrounding tissues following the surgical procedure.
The sensation of needing to urinate when you exert yourself or the discomfort when lying back could indicate that the bladder or surrounding structures are still sensitive or healing. It is essential to monitor these symptoms closely, as they may improve with time as your body heals. However, if the pain persists or worsens, it is crucial to follow up with your healthcare provider for further evaluation. They may consider imaging studies or additional examinations to rule out any complications, such as scar tissue formation or other underlying issues.

Regarding the anal itching and discharge you mentioned, this could be a separate issue. Anal itching can be caused by various factors, including irritation, infections, or skin conditions. If you suspect that the discharge is fecal in nature, it may indicate a problem with bowel control or an anal fissure, which can occur due to trauma or irritation. It is advisable to discuss these symptoms with your healthcare provider, as they can provide a thorough examination and appropriate treatment options.

In summary, while your symptoms following the umbilical urinary fistula surgery may be related to the surgical procedure and healing process, it is essential to communicate openly with your healthcare provider about any new or worsening symptoms. They can help determine the best course of action to address your concerns and ensure your recovery is on track. Additionally, addressing the anal itching and any associated symptoms will be important for your overall well-being.

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