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1 results

  • Chapter 14.3 - Fetal urinary tract obstruction

  • from Section 2 - Fetal disease
  • Edited by Mark D. Kilby, Anthony Johnson, Baylor College of Medicine, Texas, Dick Oepkes
  • Book:
    Fetal Therapy
    Published online:
    05 February 2013
    Print publication:
    13 December 2012, pp 253-260

  • Summary

    The natural history of lower urinary tract obstruction (LUTO) is dependent on the degree of bladder outflow obstruction (complete or partial) and gestational age at presentation. These two factors may be inter-related since complete bladder obstruction is associated with earlier manifestations of the obstructive uropathy. Prenatal ultrasonography is a fundamental method to assess other associated anomalies as well as to evaluate the renal characteristics which are important prognostic factors. MRI may provide more detailed analysis of the urethral obstruction, although it has not been demonstrated to date that this method can determine the underlying etiology of the LUTO. The advantages of fetal cystoscopy may be to permit a more physiological drainage of the obstructed bladder and an endoscopic examination of the dilated posterior urethra allowing the diagnosis of the cause of the obstructive uropathy (posterior urethral valves (PUV) or urethral atresia (UA)).