title: Prenatal and postnatal urologic complications of sacrococcygeal teratomas.
abstract: OBJECTIVE
  Urologic complications are an underappreciated sequelae of the mass effect of sacrococcygeal teratoma (SCT) and its resection. The goal of this study was to evaluate the incidence and severity of urologic complications in patients with SCT.
  
  
  METHODS
  A retrospective review of patients with a prenatal diagnosis of SCT and postnatal referral for SCT at a single institution during a 5-year period (2004-2009) was performed. The presence of prenatal and postnatal urologic abnormalities were collected and analyzed.
  
  
  RESULTS
  Thirty patients were identified for inclusion in the study. Twenty-two patients were diagnosed prenatally, 3 patients were referred for resection of the tumor, and 5 patients were initially treated elsewhere and referred after resection for urologic complications. Of the 20 patients with subsequent follow-up included in this study, 9 had neurogenic bladder, 5 of whom also had associated renal injury. All patients with renal injury had a higher grade Altman type II/III lesion.
  
  
  CONCLUSIONS
  Urologic problems appear to be common in patients with SCT. Higher grade SCTs should alert the surgeon to possible urologic sequelae, particularly neurogenic bladder and renal injury. Careful urologic evaluation and management of the genitourinary tract should be included in prenatal and preoperative counseling.
authors.affiliation: The Fetal Care Center of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. louis.le@cchmc.org
authors.forename: Louis D
authors.initials: LD
authors.lastname: Le
authors.forename: Shumyle
authors.initials: S
authors.lastname: Alam
authors.forename: Foong-Yen
authors.initials: FY
authors.lastname: Lim
authors.forename: Sundeep G
authors.initials: SG
authors.lastname: Keswani
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Crombleholme
mesh_terms: D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D011181:Postnatal Care; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D011296:Prenatal Diagnosis / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012445:Sacrococcygeal Region / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013724:Teratoma / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000453:epidemiology*; D014551:Urinary Tract / Q000002:abnormalities / Q000601:surgery; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery