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Prenatal incision of ureterocele causing bladder outlet obstruction: a multicenter case series
Author(s) -
Chalouhi Gihad E.,
Morency AnneMaude,
De Vlieger Roland,
Martinez José Maria,
Blanc Thomas,
Hodges Ryan,
Gueneuc Alexandra,
Ryan Greg,
Deprest Jan,
Gratacos Eduard,
Ville Yves
Publication year - 2017
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.5091
Subject(s) - medicine , ureterocele , surgery , bladder outlet obstruction , gestational age , prenatal diagnosis , amniotic fluid index , amniotic fluid , obstetrics , fetus , pregnancy , ureter , prostate , cancer , biology , genetics
We reviewed data from a cohort of fetuses with ureterocele diagnosed and operated prenatally in four fetal therapy centers. Inclusion criteria were (1) ureterocele confirmed on detailed fetal ultrasound examination, (2) absence of additional fetal malformations, and (3) fetal intervention to decompress the ureterocele with local institutional review boards' approval. Data on sonographic follow‐up, obstetrical, neonatal outcome, and postnatal evaluation were collected. Ten cases of prenatally treated ureterocele are described. Six cases benefited from a fetoscopy for laser incision and decompression, two cases had an ultrasound guided puncture before resorting to a fetoscopy with laser incision, one case had a balloon catheterization under ultrasound guidance, and one case had an ultrasound‐guided opening of the ureterocele with a laser fiber passed through a 20‐gauge needle. Mean gestational age at diagnosis was 21.6 GW. Two cases underwent termination of pregnancy. The remaining eight cases recovered normal amniotic fluid volume and delivered a liveborn child at a mean gestational age of 38.6 GW with normal creatinine levels during the first week of life. Prenatal incision provided complete treatment of severely obstructive ureteroceles in 80% of the cases and allowed improvement of urinary electrolytes, renal size and echogenicity, bladder filling in all survivors, and recollection of normal amniotic fluid volume, in case of oligoanhydramnios. © 2017 John Wiley & Sons, Ltd.