Malignancy yield and clinical predictors in radiologically detected adult urachal anomalies: A retrospective cohort study.
4 affiliations
- 1Department of Urology, Institute of Clinical Science Sahlgrenska Academy, University of Gothenburg Gothenburg Sweden.
- 2Department of Surgery, Urology Section NU-Hospital Group Uddevalla Region Västra Götaland Sweden.
- 3Bra Liv Hälsan. Primary Care Centre Region Jönköping County Sweden.
- 4Department of Research and Development NU-Hospital Group Trollhättan Region Västra Götaland Sweden.
Abstract
Objective
To evaluate the occurrence of bladder malignancy or papillary urothelial neoplasm of low malignant potential (PUNLMP) detected at initial evaluation or during follow-up among adults with radiologically reported urachal anomalies, and to explore clinical factors associated with neoplasia.Materials and methods
We conducted a retrospective single-centre cohort study. Adult patients with radiologically reported urachal anomalies between 2000 and 2024 were identified through institutional radiology information system and report archive and underwent detailed chart review. Patients with a prior history of bladder or upper urinary tract malignancy were excluded. Clinical presentation, imaging findings, cystoscopy, histopathology and outcomes were analysed. Clinical variables associated with malignancy were explored using Firth penalized logistic regression.Results
A total of 245 patients were included: 92/245 (38%) had incidental/asymptomatic findings and 153/245 (62%) were symptomatic. Bladder malignancy/PUNLMP was detected in 14/245 patients (5.7%) overall, including 0/92 incidental/asymptomatic patients (0%) and 14/153 symptomatic patients (9.2%). Macroscopic haematuria was present in 12/14 patients with malignancy/PUNLMP and was associated with a higher frequency of neoplasia: 12/66 patients with haematuria (18%) versus 2/179 without haematuria (1%; p<0.001). In exploratory multivariable analysis, macroscopic haematuria remained associated with malignancy/PUNLMP (OR 5.29, 95% CI 1.10-39.5). Most detected tumours were of non-urachal histology, and 8/14 (57%) were stage T2 or higher.Conclusions
Incidentally detected urachal anomalies in adults were not associated with malignancy during follow-up, suggesting that conservative management may be appropriate in asymptomatic patients. In contrast, symptomatic presentation, particularly macroscopic haematuria, warrants thorough urological evaluation due to its association with a substantially increased risk of bladder malignancy.
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BibTeX
@article{blomqvist2026malignancy,
title = {{Malignancy yield and clinical predictors in radiologically detected adult urachal anomalies: A retrospective cohort study.}},
author = {Per Blomqvist and Lala Joulhay Ian and Emelie Holmin and Suleiman Abuhasanein},
journal = {BJUI compass},
year = {2026},
month = oct,
doi = {10.1002/bco2.70284},
url = {https://europepmc.org/article/MED/42840620},
note = {CC BY},
}
RIS
TY - JOUR
TI - Malignancy yield and clinical predictors in radiologically detected adult urachal anomalies: A retrospective cohort study.
AU - Per Blomqvist
AU - Lala Joulhay Ian
AU - Emelie Holmin
AU - Suleiman Abuhasanein
PY - 2026
DA - 2026/10/06
JO - BJUI compass
DO - 10.1002/bco2.70284
UR - https://europepmc.org/article/MED/42840620
AB - Objective To evaluate the occurrence of bladder malignancy or papillary urothelial neoplasm of low malignant potential (PUNLMP) detected at initial evaluation or during follow-up among adults with radiologically reported urachal anomalies, and to explore clinical factors associated with neoplasia.Materials and methods We conducted a retrospective single-centre cohort study. Adult patients with radiologically reported urachal anomalies between 2000 and 2024 were identified through institutional radiology information system and report archive and underwent detailed chart review. Patients with a prior history of bladder or upper urinary tract malignancy were excluded. Clinical presentation, imaging findings, cystoscopy, histopathology and outcomes were analysed. Clinical variables associated with malignancy were explored using Firth penalized logistic regression.Results A total of 245 patients were included: 92/245 (38%) had incidental/asymptomatic findings and 153/245 (62%) were symptomatic. Bladder malignancy/PUNLMP was detected in 14/245 patients (5.7%) overall, including 0/92 incidental/asymptomatic patients (0%) and 14/153 symptomatic patients (9.2%). Macroscopic haematuria was present in 12/14 patients with malignancy/PUNLMP and was associated with a higher frequency of neoplasia: 12/66 patients with haematuria (18%) versus 2/179 without haematuria (1%; p<0.001). In exploratory multivariable analysis, macroscopic haematuria remained associated with malignancy/PUNLMP (OR 5.29, 95% CI 1.10-39.5). Most detected tumours were of non-urachal histology, and 8/14 (57%) were stage T2 or higher.Conclusions Incidentally detected urachal anomalies in adults were not associated with malignancy during follow-up, suggesting that conservative management may be appropriate in asymptomatic patients. In contrast, symptomatic presentation, particularly macroscopic haematuria, warrants thorough urological evaluation due to its association with a substantially increased risk of bladder malignancy.
SN - 2688-4526
ER -