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Rare developmental anomalies known as urachal remnants are brought on by flaws in the foetal developmental process. However, depending on the location and degree of incomplete obliteration, the urachus can undergo a variety of urachal anomalies. An umbilical fistulogram and a voiding cystourethrogram both supported the existence of the adult urachal cyst in this case.

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Vesicoumbilical fistula in the adult male basically results from repermeability of the urachus obliterated by an uncompensated vesicoprostatic obstruction. The passage of urine through the umbilicus is practically pathognomonic and the definitive diagnosis is made by IVP and cystourethrography. It is a relatively benign pathology with a good prognosis following surgical treatment.

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A vesico-umbilical fistula occurred following cut down for catheterization of the umbilical artery in a premature infant; a previously unreported complication. Knowledge of the variations in anatomical structure of the urachus and umbilical arteries at birth will help to prevent this complication.

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