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Fetoscopic urethral meatotomy in fetuses with lower urinary tract obstruction by congenital megalourethra
Author(s) -
CruzMartínez Rogelio,
MartínezRodríguez Miguel,
GámezVarela Alma,
LunaGarcía Jonahtan,
LópezBriones Hugo,
ChávezGonzález Erendira,
VillalobosGómez Rosa,
JuárezMartínez Israel
Publication year - 2021
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.5946
Subject(s) - medicine , urinary system , urinary tract obstruction , fetus , fetoscopy , urinary obstruction , urethra , urology , surgery , prenatal diagnosis , pregnancy , anatomy , biology , genetics
Background To describe the perinatal outcomes of fetoscopic urethral meatotomy (FUM) in fetuses with lower urinary tract obstruction (LUTO) by congenital megalourethra. Study design Between 2012 and 2020, 226 cases with LUTO were referred to our fetal surgery center in Queretaro, Mexico. We report the perinatal outcome of cases with LUTO by congenital megalourethra that were selected for FUM in an attempt to release the penile urethral obstruction. Results Congenital megalourethra was diagnosed in 10 cases (4.4%) but only 3 cases (30%) with obstructive megalourethra and megacystis were selected for fetal surgery. Fetoscopic urethral metatotomy was successfully performed in all three cases at a median gestational age (GA) of 21.4 (18.0–26.7) weeks and with a median surgical time of 27 (12–43) min. A resolution of urethral dilatation and subsequent reduction of the penile length and normalization of both the bladder size and amniotic fluid were observed in all cases. The median GA at delivery was 35.2 (range: 30.6–38.0) weeks. There were no fetal deaths but one neonatal death (33%) secondary to renal failure and preterm delivery. Conclusion In fetuses with LUTO by congenital obstructive megalourethra, FUM is feasible and is associated with good perinatal outcomes.