Case report: Fistula formation of a urachal cyst 6 years after prostatectomy

Urachal cysts can be a diagnostic dilemma, because determining whether the cyst is malignant can be difficult. As a result, the best treatment is not always obvious. Urachal malignancies account for less than 1 % of total bladder cancer cases thus in most cases urachal cysts are benign, and a watchful waiting approach is justified. However, in cases with symptoms or a suspicion of malignancy, there is an indication for surgical resection. Here, we discuss the management of a symptomatic large persistent urachal cyst in a patient that had undergone a radical prostatectomy which was complicated by recto-vesical fistula.