Abstract
Results: A total of 13 patients met inclusion criteria and were offered fetal cystoscopy and possible laser fulguration with confirmation of PUV. Seven patients decided to undergo fetal therapy and six elected to continue with expectant observation. There was no difference between both groups in gestation age at diagnosis and referral examinations or fetal urinary analysis. Urethral atresia was diagnosed in three cases (21.3%). At 26 weeks, fetuses that were managed expectantly presented with worse urinary biochemistry results (p < 0.05). Survival rates and percentage of infants with normal renal function were significantly higher in the cystoscopic laser group than in those cases that decided for prenatal expectant management. Conclusions: Percutaneous fetal cystoscopy is feasible using a thinner special cannula for prenatal diagnosis and therapy of LUTO. Prenatal laser ablation of the posterior urethra valves under cystoscopy may prevent renal function deterioration improving postnatal outcomes.
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