Summary
In-utero vesica-amniotic shunting for fetal lower urinary obstruction (LUTO) is known
to improve perinatal survival. More recently, studies including centres performing
fetal cystoscopy, have suggested benefit on longer-term survival and renal outcome
– within the limitations of small numbers and limited follow-up. These interventions
carry significant risk, and therefore patient selection, and optimal timing, are key.
The aim of this article is to explore ways of improving the accuracy of prenatal diagnosis,
and of identifying risk factors for fetal and postnatal renal failure. The next step
is that of using established staging and classification systems to select the patient
group that may benefit from intervention, based on published outcomes. Several factors
come into play when selecting the timing of intervention, especially if the aim is
that of renal, and not only pulmonary, preservation. Lastly, current technologies
and their shortfalls are discussed.
Keywords
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Article info
Publication history
Published online: January 31, 2021
Accepted:
January 24,
2021
Received in revised form:
December 30,
2020
Received:
September 11,
2020
Identification
Copyright
© 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
