title: Cystoscopic placement of transurethral stent in a fetus with urethral stenosis.
abstract: We report the case of a fetus with severe megabladder, displaying the 'keyhole' sign on ultrasound imaging, that underwent cystoscopy at 22 weeks' gestation. There was a familial history of mild urethral atresia. Fetal cystoscopy revealed congenital urethral atresia. A guide wire was advanced through the fetal urethra and a transurethral vesicoamniotic stent was placed successfully. The fetus was delivered at 36 weeks' gestation and postnatal cystoscopy confirmed the absence of posterior urethral valves or urethral atresia. The infant was 5 years old with normal renal function at the time of writing. We conclude that fetal cystoscopic placement of a transurethral stent for congenital urethral stenosis is feasible.
authors.affiliation: Department of Obstetrics and Gynecology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: R
authors.initials: R
authors.lastname: Ruano
authors.forename: C T
authors.initials: CT
authors.lastname: Yoshizaki
authors.forename: A M
authors.initials: AM
authors.lastname: Giron
authors.forename: M
authors.initials: M
authors.lastname: Srougi
authors.forename: M
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D002404:Catheterization; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D005333:Fetus / Q000601:surgery*; D005865:Gestational Age; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D015607:Stents; D016216:Ultrasonography, Prenatal / Q000379:methods; D014521:Urethra / Q000000981:diagnostic imaging* / Q000196:embryology; D014524:Urethral Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000601:surgery*; D001743:Urinary Bladder / Q000002:abnormalities / Q000000981:diagnostic imaging
keywords: cystoscopy; fetal lower urinary tract obstruction; fetal surgery; laser therapy; posterior urethral valves; urethral atresia; urethral stenosis; vesicoamniotic shunting