After 2 years of mucusuria a villous adenoma of the urachus was resected from a woman by partial cystectomy and excision of the entire urachus. Convalescence was uneventful and the patient was well 12 months later. Urachal adenomas are rare, this being the sixteenth case reported. Generally, they are multilocular cystic tumors lined by columnar epithelium with a population of mucous goblet cells. Often, there is a striking resemblance to gut epithelium. Ultrastructurally, by transmission and scanning electron microscopy, the tissue resembles gut mucosa. Urinary mucus is a common and relatively specific symptom for adenomas of the lower urachus, occurring in 7 of 11 cases. Resection alone is effective therapy but care must be exercised to avoid spilling adenoma cells in the peritoneum.

Of the 132 transplants in our series 44 patients underwent reconstruction by ureteropyelostomy (group 1) and 88 underwent reconstruction by ureteroneocystostomy (group 2). The rates of major urologic complications were 11 percent in group 1 and 4 per cent in group 2. These results support the widely held opinion that ureteroneocystostomy is the superior method for urinary reconstruction in renal allograft cases. However, the alternative of ureteropyelostomy should be part of every transplant surgeons' armamentarium, especially for cadaver transplants when ureteral blood supply may be compromised.