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Background: An infected urachal cyst is an uncommon finding in adults., Aim: To report a case of a sigmoid- urachal- cutaneous fistula., Case Report: A 51 years old adult male presented with fecaloid leaking from rupture of an infected urachal cyst. Definitive management consisted of resection of the urachus with a bladder cuff, along with removal of the affected bowel segments., Conclusion: Colo-urachal-cutaneous fistula is a rare condition; its management is rather complex.

One case of inflammatory pseudo-tumor revealed by mictional disorders is reported. Ultrasonography and computed tomography visualised a non specific formation of bladder dome witch extend to the Retzius space and umbilicus. The diagnosis of urachal tumor had been suspected. Anatomopathologic analysis of the operative piece disclose a diagnosis of the urachal remnants with foreign body type of inflammation. Since malignant transformation of urachal remnants is possible, surgical resection is advised.

Cancers of the urachus are very infrequent, making up 0.1% to 0.7% of all bladder tumors. This type of tumor affects male subjects in 60% to 75% of cases, in the 5th or 6th decade of live. In more than 90% of all cases, the lesion is a mucosecretory adenocarcinoma developing from embryonic remains within the wall of the bladder and respecting the superficial urothelium of the bladder, which is affected only secondarily, contrary to what occurs in the other adenocarcinomas of the bladder. The pathogenesis remains controversial, especially in the role of urachus patency and of bladder carcinogens. The diagnosis is most often established late, because of a long clinical latency. It is mainly based on ultrasonography and CT scan. Explorations of the bladder are useful only at an advanced stage. The prognosis is very poor, survival at 5 years ranging from 6.5% to 25% according to the authors. The treatment is mainly surgical. Only extensive resection with partial cystectomy extending to the peri- and supravesical environment, including the peritoneum and the umbilicus, and associated with pelvic lymphadenectomy may give some hope. Chemotherapy and radiation therapy, either alone or adjuvant, are disappointing. The prognosis may be improved only by an early diagnosis.

We report a case of mucin-producing adenocarcinoma of the urachus. Preoperative diagnosis was established by computerized axial tomography. An en bloc resection was performed, including the urachus with supravesical mass and bladder dome.

26 cases of urachus anomalies are reviewed. Embryological, clinical and therapeutic problems are discussed. The authors point out the importance of a systematic urinary tract evaluation. Relationship between urachus anomalies and "prunebelly" syndrome is considered.

Reviewing 5 recent cases, different anatomical and clinical forms of partial or complete urachal persistency are described: patent urachus, urachal cyst, urachal sinus and urachal diverticulum. The risk of late malignant evolution of this embryonic vestige justifies radical surgical removal at time of diagnosis.