Baifeng Chen, Bingliang Li, Wei Wang, Dong Wang, Tianhua Luo, Xuhui Zhang
In infants (≤12 months of age) with first-time infected urachal cysts, the majority achieve complete cyst resolution after nonoperative management. The observation that all surgical cases clustered within 3 months after infection control warrants attention, but it should not be used as a definitive surgical decision threshold. These conclusions are based on short-term follow-up data; long-term safety requires further confirmation through extended follow-up.
OBJECTIVES: To investigate the clinical characteristics and outcomes of nonoperative management in infants aged ≤12 months with first-time infected urachal cysts, with a focus on comparing treatment responses between the ≤6-month and 6-12-month age groups.
METHODS: A retrospective analysis was conducted on clinical data and follow-up outcomes of infants aged ≤12 months with first-time infected urachal cysts admitted between January 2012 and January 2026. All patients initially received nonoperative management (including antibiotic therapy alone, or antibiotic therapy combined with ultrasound-guided percutaneous drainage). Clinical characteristics and cyst regression were recorded. Patients were stratified by age into the ≤6-month group and the 6-12-month group for comparison. Cyst outcomes were classified into three categories: complete resolution, marked regression (≥50% reduction with residual lesions), and treatment failure (requiring surgery).
RESULTS: A total of 49 infants were enrolled. Umbilical local manifestations were the most common presenting symptoms (79.6%), and the abscess formation rate was 75.5%. The complete resolution rate was 79.6% (39/49), the marked regression rate was 8.2% (4/49), and the eventual surgical rate was 12.2% (6/49). The complete resolution rates were 77.3% and 81.5% in the ≤6-month and 6-12-month groups, respectively; however, the younger group had a significantly higher rate of percutaneous drainage (90.9% vs. 62.9%, P = 0.024). All infants who required surgery had their surgical indications established within 3 months after infection control.
CONCLUSIONS: In infants (≤12 months of age) with first-time infected urachal cysts, the majority achieve complete cyst resolution after nonoperative management. The observation that all surgical cases clustered within 3 months after infection control warrants attention, but it should not be used as a definitive surgical decision threshold. These conclusions are based on short-term follow-up data; long-term safety requires further confirmation through extended follow-up.