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Prenat Diagn. 2017 Oct;37(10):968-974. doi: 10.1002/pd.5091. Epub 2017 Aug 24.

Prenatal incision of ureterocele causing bladder outlet obstruction: a multicenter case series.

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Fetal Medicine Unit, Obstetrics and Fetal Medicine Department, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Fetal Medicine Unit, Department of Obstetrics & Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Belgium.
BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clınic and Hospital Sant Joan de Dieu, IDIBAPS, University of Barcelona, and Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain.
Department of Pediatric Surgery, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.


We reviewed data from a cohort of fetuses with ureterocele diagnosed and operated prenatally in four fetal therapy centers. Inclusion criteria were (1) ureterocele confirmed on detailed fetal ultrasound examination, (2) absence of additional fetal malformations, and (3) fetal intervention to decompress the ureterocele with local institutional review boards' approval. Data on sonographic follow-up, obstetrical, neonatal outcome, and postnatal evaluation were collected. Ten cases of prenatally treated ureterocele are described. Six cases benefited from a fetoscopy for laser incision and decompression, two cases had an ultrasound guided puncture before resorting to a fetoscopy with laser incision, one case had a balloon catheterization under ultrasound guidance, and one case had an ultrasound-guided opening of the ureterocele with a laser fiber passed through a 20-gauge needle. Mean gestational age at diagnosis was 21.6 GW. Two cases underwent termination of pregnancy. The remaining eight cases recovered normal amniotic fluid volume and delivered a liveborn child at a mean gestational age of 38.6 GW with normal creatinine levels during the first week of life. Prenatal incision provided complete treatment of severely obstructive ureteroceles in 80% of the cases and allowed improvement of urinary electrolytes, renal size and echogenicity, bladder filling in all survivors, and recollection of normal amniotic fluid volume, in case of oligoanhydramnios.

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