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...

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Bibliographic Details
Published in:Current urology reports 2018-01, Vol.19 (1), p.12-12, Article 12
Main Authors: Clayton, Douglass B., Brock, John W.
Format: Article
Language:English
Subjects:
Medicine
Medicine & Public Health
Nephrology
Pediatric Urology (D Weiss
Section Editor
Topical Collection on Pediatric Urology
Urology
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Summary: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.
ISSN:1527-2737
1534-6285
DOI:10.1007/s11934-018-0760-9