title: Is a vesicoamniotic shunt intrinsically bad? Shunting a normal fetal bladder.
abstract: BACKGROUND
  We previously demonstrated that in utero vesicoamniotic shunting of obstructive uropathy in fetal lambs produces a shrunken noncompliant bladder. We hypothesized that the normal fetal bladder filling and emptying cycle in fetal life is critical to the development of normal bladder function.
  
  
  METHODS
  We placed vesicoamniotic shunts in 4 normal fetal lambs at 74 days' gestation. The fetuses were delivered at term (145 days), and bladder volume and compliance were measured and compared with those measurements in 3 normal term fetuses. The lambs were then killed and the renal tracts and bladders removed submitted to histologic examination.
  
  
  RESULTS
  All shunted lambs survived to term. Three normal control lambs were delivered at term. The mean bladder volume in shunted lambs was 4 +/- 2.8 mL (n = 4) compared with 60 +/- 17 mL (n = 3) in control lambs (P < .05). Bladders in the shunted lambs had very poor compliance compared with normal lambs' bladders. Histologic examination of the shunted bladders showed increased fibrosis and distortion of the muscle layers compared with control bladders.
  
  
  CONCLUSIONS
  Even in the absence of obstruction, preventing normal bladder filling and emptying in fetal life produces fibrotic bladders with poor compliance.
authors: Division of Pediatric Surgery, St Marianna University School of Medicine, 2-16-1, Sugao, Miyamal-ku, Kawasaki 216-8511, Japan. h2kita@marianna-u.ac.jp
authors: Hiroaki
authors: H
authors: Kitagawa
authors: Kevin C
authors: KC
authors: Pringle
authors: Junki
authors: J
authors: Koike
authors: Hideki
authors: H
authors: Nagae
authors: Jane
authors: J
authors: Zuccollo
authors: Takeshi
authors: T
authors: Aoba
authors: Yasuji
authors: Y
authors: Seki
authors: Chiai
authors: C
authors: Nagae
authors: Mamoru
authors: M
authors: Tadokoro
mesh_terms: D000650:Amnion / Q000601:surgery*; D000714:Anastomosis, Surgical; D000818:Animals; D005260:Female; D005315:Fetal Diseases / Q000601:surgery*; D023421:Models, Animal; D011247:Pregnancy; D011270:Pregnancy, Animal; D011897:Random Allocation; D012016:Reference Values; D012680:Sensitivity and Specificity; D012756:Sheep; D014524:Urethral Obstruction / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*