Evaluation of Vesicocentesis Procedure in Patients with Megacystis: A Retrospective Analysis

Abstract

Objective: To evaluate the patients who underwent vesicocentesis for fetal megacystis. Material and Methods: Patients who underwent vesicocentesis between May 2021 and May 2022 in İzmir Tepecik Training and Research Hospital's Perinatology Department were evaluated retrospectively. Data were collected from the hospital database. Demographic characteristics of patients, indications, laboratory findings, clinical outcomes, and complications of vesicocentesis procedure were evaluated. Results: Vesicocentesis was performed in 25 patients with fetal megacystis. The mean age of the population was 27.6 years (range: 20-36 years) and the mean gestational week at the time of procedure was 18.9 weeks (range: 13-31 weeks). Hydronephrosis was observed in 6 (24%) patients. Multiple organ malformations were observed in 5 (20%) patients. Genetic examination was performed for all fetuses. CHRM3 gene mutation and Prune-belly syndrome were found in 1 (4%) patient. The mean values of the markers examined by vesicocentesis were found as follows: sodium (104.1 mg/dL), chloride (91.5 mg/dL), osmolality (246.5 mOsm/L), calcium (6.4 mg/dL), total protein (35.2 mg/dL), and β2-microglobulin (9.6 mg/L). Vesicoamniotic shunt procedure was performed to 7 (28%) patients. In one (4%) patient, the shunt was reinserted because of the displacement into the intraamniotic cavity. After the vesicocentesis procedure, premature rupture of membranes or intrauterine bleeding did not develop, but one (4%) patient underwent cesarean delivery due to fetal distress. Conclusion: Vesicocentesis could provide information that can be useful when deciding whether a fetus with megacystis could benefit from vesicoamniotic shunting. However, the long-term effects of vesicoamniotic shunting on these fetuses need to be determined to establish the true clinical effectiveness and cost-effectiveness of the intervention.