To excise or not to excise infected urachal cysts - JPS July
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A 9-year-old male presented to the emergency department complaining of dysuria and suprapubic pain, worsening over two months. The patient had been diagnosed at 5 years of age with primary incontinence based on ultrasound and urodynamic studies revealing incomplete emptying of the bladder. The patient was treated with a timed-voiding regimen and training in Kegel exercises which resulted in significant improvement that lasted until 2 months prior to hospital admission. Now, at 9 years of age, he presented with new complaints of worsening dysuria and suprapubic pain present while both voiding and walking. There was no fever, hematuria, frequency, urgency, nor any worsening of urinary continence. There was no history of any constipation, vomiting or diarrhea, nor had he ever had a urinary tract infection. Family history was noncontributory. An ultrasound examination was performed 2 weeks prior to admission which revealed a 1.6 cm cystic structure along the anterior aspect of the bladder .....

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