Current State of Fetal Intervention for Lower Urinary Tract Obstruction

Current State of Fetal Intervention for Lower Urinary Tract Obstruction Purpose of the Review In this article, we explore the origins of intervention of fetal lower urinary tract obstruction, and we specifically discuss the background and recent outcomes of vesicoamniotic shunt placement and fetal cystoscopy. The article seeks to provide a comprehensive overview of the field while bringing the reader quickly up to speed on the pertinent literature and the critical data that are available to guide decision-making regarding intervention. Recent Findings Appropriate patient selection for fetal intervention remains challenging despite advances in prenatal imaging. Both a randomized controlled trial and multiple systematic reviews show evidence of a perinatal survival benefit following fetal intervention but rates of renal morbidity remain very high. Summary Despite 30 years of research, fetal lower urinary tract obstruction remains a difficulty entity to treat. Intervention may lead to survival, but physicians and caregivers must remain alert for the distinct possibility of long-term renal morbidity in survivors. . . . . Keywords Fetal lower urinary tract obstruction Fetal intervention Vesicoamniotic shunt Fetal cystoscopy Second trimester . . oligohydramnios Fetal hydronephrosis Fetal posterior urethral valves Introduction development specifically to relieve LUTO has been a reality for several decades. Yet, several challenges remain and specif- A congenital http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Current Urology Reports Springer Journals

Current State of Fetal Intervention for Lower Urinary Tract Obstruction

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Publisher
Springer US
Copyright
Copyright © 2018 by Springer Science+Business Media, LLC, part of Springer Nature
Subject
Medicine & Public Health; Urology; Nephrology
ISSN
1527-2737
eISSN
1534-6285
D.O.I.
10.1007/s11934-018-0760-9
Publisher site
See Article on Publisher Site

Abstract

Purpose of the Review In this article, we explore the origins of intervention of fetal lower urinary tract obstruction, and we specifically discuss the background and recent outcomes of vesicoamniotic shunt placement and fetal cystoscopy. The article seeks to provide a comprehensive overview of the field while bringing the reader quickly up to speed on the pertinent literature and the critical data that are available to guide decision-making regarding intervention. Recent Findings Appropriate patient selection for fetal intervention remains challenging despite advances in prenatal imaging. Both a randomized controlled trial and multiple systematic reviews show evidence of a perinatal survival benefit following fetal intervention but rates of renal morbidity remain very high. Summary Despite 30 years of research, fetal lower urinary tract obstruction remains a difficulty entity to treat. Intervention may lead to survival, but physicians and caregivers must remain alert for the distinct possibility of long-term renal morbidity in survivors. . . . . Keywords Fetal lower urinary tract obstruction Fetal intervention Vesicoamniotic shunt Fetal cystoscopy Second trimester . . oligohydramnios Fetal hydronephrosis Fetal posterior urethral valves Introduction development specifically to relieve LUTO has been a reality for several decades. Yet, several challenges remain and specif- A congenital

Journal

Current Urology ReportsSpringer Journals

Published: Feb 22, 2018

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