Fetal cystoscopy will be performed under maternal local anesthesia and fetal anesthesia. The dilated posterior urethra will be directly evaluated. Laser fulguration will be performed in case of posterior urethral valves. However, if a non membrane-like structure is found, even with the fluid injection or the guide-wire, urethral atresia (UA, US or Prune Belly syndrome) will be diagnosed and we will not attempt to perforate this structure. A vesicoamniotic shunting placement will be performed in this situation depending on the patient's consent prior to the surgery.

The fetal vesicoamniotic shunt is considered the standard prenatal therapy for severe LUTO. Amnioinfusion and vesicoamniotic shunt placement will be performed under ultrasound guidance.

Those patients that refuse fetal intervention and do not elect to terminate the pregnancy will be followed as part of the no fetal intervention group.

Urethral Obstruction

Fetal Cystoscopy

Fetal vesicoamniotic shunt will be performed under ultrasound guidance

Fetal vesicoamniotic shunt

Texas Children's Hospital Pavilion for Women

Fetal Cystoscopy for Lower Urinary Tract Obstruction

Fetal Cystoscopy for Severe Lower Urinary Tract Obstruction - a Prospective Trial

We will evaluate the survival rate at 2 years of life

We will evaluate the renal function at 2 years of life based on the glomerular filtration rate (GFR). In addition, we will evaluate the need for dialysis and renal transplant.

Michael Belfort

MD PhD, Professor Baylor College of Medicine and Co-Director Texas Children's Fetal Center

Baylor College of Medicine

This study is an un-blinded, non-randomized, single arm Phase 1 study. Fetal intervention is usually offered to patients carrying fetuses with isolated LUTO that meet the inclusion criteria. Once the patient elected to have fetal intervention, fetal cystoscopy will be offered as an experimental procedure as an option to fetal vesico-amniotic shunting.

Comparison study between KTP and HoLAP procedures for BPH

Benign Prostatic Hyperplasia

Comparison study between KTP and HoLAp for BPH

urethral stricture/draslík

Fetal Cystoscopy for Lower Urinary Tract Obstruction

Holmium Laser Ablation of the Prostate (HoLAP) Versus KTP Laser Vaporization of the Prostate

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