Surgery is recommended for a patent urachus that does not close after birth. There is some variablity in the degree of the defect. Sometimes, only the umbilical end of the urachus fails to close, generating a urachal sinus, which does not connect with the bladder, but simply eneters the skin for a short distance. These can usually be excised locally. If the entire urachus is patent all the way to the bladder, the urachus must be excised and the bladder closed.