Prenatal intervention for urinary obstruction and myelomeningocele.
Widespread use of ultrasonography has resulted in an increase in the recognition of fetal hydronephrosis. The enthusiasm that accompanied early interventions has been tempered by the experience and results obtained over the past 2 decades. The goal has remained the same: to identify patients with serious prenatal obstruction and to identify those which may benefit from intervention. Myelomeningocele remains a devastating congenital anomaly. Fetal and experimental studies suggested that patients with myelomeningocele could benefit from prenatal intervention. Advances in technology and perinatal management have made intervention for more complex malformations such as myelomeningocele possible. This article will review current knowledge and will detail rational management for the management of prenatal hydronephrosis. The current state of antenatal myelomeningocele repair and the urologic implications will be described as well.
Swana
Hubert S
HS
Department of Urology, University of California San Francisco, San Francisco, California 94143-0330, USA. lbaskin@urol.ucsf.edu
Sutherland
Ronald S
RS
Baskin
Laurence
L
D000328:Adult; D005260:Female; D047109:Fetal Development; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008591:Meningomyelocele / Q000175:diagnosis* / Q000601:surgery*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D016216:Ultrasonography, Prenatal; D014524:Urethral Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*