VESICO-UMBILICAL URINARY FISTULA

Escape of urine from the bladder through the umbilicus is a phenomenon rarely observed clinically. Occasionally there may be a congenital absence of the urachus with a consequent direct communication between the upper part of the bladder and the umbilicus, or there may be the so-called persistent urachus. In the latter case, as will be seen, there is really only the abnormal persistence of a part of the urachus in communication with the bladder; there is no direct continuation of the urachus to the umbilicus, but conditions may arise in which the urine may be forced through the persisting remnant of the urachus and thence through the tissues intervening between it and the umbilicus, finding an outlet through the latter. This is not a true urachal fistula but a vesico-umbilical fistula, although frequently described in the literature as a persisting urachus. We have recently treated a case of vesicoumbilical fistula