| Fetal cystoscopy for severe lower urinary tract obstruction--initial experience of a single center. | |
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MedLine Citation:
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PMID: 19967749 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To report the experience with fetal cystoscopy and laser fulguration of posterior urethral values (PUV) for severe lower urinary tract obstruction (LUTO). METHODS: Between July 2006 and December 2008, fetal cystoscopy was offered to 23 patients whose fetuses presented with severe LUTO, favorable urinary analysis and gestational age <26 weeks. Fetal urinary biochemistry was evaluated before and after cystoscopy. All infants were followed 6-12 months after birth. Abnormal renal function was defined when serum creatinine higher than 50 micromol/L (2 Standard Deviation) or the necessity of dialysis or renal transplantation. Autopsy was always performed whenever fetal or neonatal deaths occurred. RESULTS: Eleven patients decided to undergo fetal therapy and 12 elected to continue with expectant observation. There was no difference between both groups in gestation age at diagnosis and referral examinations. Urethral atresia was diagnosed in 4/11 (36.4%) fetuses by fetal cystoscopy. At 26 weeks, fetuses that were managed expectantly presented with worse urinary biochemistry results (p < 0.05). Survival rates and percentage of infants with normal renal function were significantly higher in the cystoscopic group than in the expectant group (p < 0.05). CONCLUSIONS: Percutaneous fetal cystoscopy is feasible using a thinner special cannula for prenatal diagnosis and therapy of LUTO. Prenatal laser ablation of the PUV under cystoscopy may prevent renal function deterioration improving postnatal outcome. |
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Authors:
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Rodrigo Ruano; Sergio Duarte; Victor Bunduki; Amilcar Martins Giron; Miguel Srougi; Marcelo Zugaib |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prenatal diagnosis Volume: 30 ISSN: 1097-0223 ISO Abbreviation: Prenat. Diagn. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-28 Completed Date: 2010-03-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8106540 Medline TA: Prenat Diagn Country: England |
Other Details:
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Languages: eng Pagination: 30-9 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2009 John Wiley & Sons, Ltd. |
Affiliation:
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Obstetrics Department, Faculty of Medicine, S?o Paulo University, Rua Valentim Magalh?es 100, S?o Paulo, SP, Brazil. rodrigoruano@hotmail.com |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cystoscopy / methods* Dilatation / instrumentation, methods Female Fetal Diseases / diagnosis*, surgery Gestational Age Humans Laser Therapy / methods Pregnancy Pregnancy Outcome Prenatal Diagnosis / methods* Prospective Studies Treatment Outcome Urethra / abnormalities*, surgery Urethral Obstruction / diagnosis*, embryology, surgery |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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