title: Two-year outcomes after diagnostic and therapeutic fetal cystoscopy for lower urinary tract obstruction.
abstract: OBJECTIVE
  Our objective is to report long-term outcome after fetal cystoscopy for lower urinary tract obstruction (LUTO), as well as to investigate the accuracy of fetal cystoscopy in diagnosing the cause of bladder outlet obstruction.
  
  
  METHODS
  This is a retrospective cohort study of all fetuses who underwent cystoscopy for prenatal diagnosis of LUTO in three tertiary referral centers. Fetal diagnostic cystoscopy was performed to determine prenatally the cause of LUTO and to ablate the posterior urethral valves (PUV).
  
  
  RESULTS
  A total of 50 fetal cystoscopies were performed, revealing PUV in 31 (62%) fetuses, urethral atresia (UA) in 14 (28%) fetuses, and urethral stenosis (US) in 5 (10%) fetuses. Two fetuses had trisomy 18 diagnosed after fetal cystoscopy and were excluded from the present analysis. Fetal cystoscopy was accurate in the diagnosis of the etiology of LUTO in 32/35 (91.4%). There were no survivors in the UA group. One fetus with US underwent urethral stenting and survived with normal renal function at 2 years of life. Among the infants with PUV, 17/30 (56.7%) infants survived, and 13/17 (76.5%) had normal renal function at 1 year of life; 15/28 (53.6%) infants survived, and 11/15 (73.3%) had normal renal function at 2 years.
  
  
  CONCLUSIONS
  Fetal cystoscopy is accurate in the diagnosis of the etiology of LUTO and serves as a guide to the specific prenatal treatment. This procedure is associated with modest long-term survival (54%) but with adequate preserved normal renal function in two thirds of the infants among fetuses with PUV.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA.|INSERM, UMR-S 1121, 'Biomatériaux et Bioingénierie', Strasbourg, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sananes
authors.affiliation: Department of Fetal Surgery, Children's and Women's Specialty Hospital of Queretaro, Queretaro, Mexico.|Unidad de Investigación en Neurodesarrollo, Instituto de Neurobiología, UNAM-Juriquilla, Queretaro, Mexico.
authors.forename: Rogelio
authors.initials: R
authors.lastname: Cruz-Martinez
authors.affiliation: Maternal Fetal Medicine Department, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Favre
authors.affiliation: Department of Pediatric Surgery, Children's Hospital Mexico 'Federico Gomez' (HIMFG), Mexico City, Mexico.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ordorica-Flores
authors.affiliation: Pediatric Surgery Department, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Raphaël
authors.initials: R
authors.lastname: Moog
authors.affiliation: Pediatric Nephrology Department, Strasbourg University Hospital, Strasbourg, France.
authors.forename: Ariane
authors.initials: A
authors.lastname: Zaloszy
authors.affiliation: Department of Urology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Amilcar Martins
authors.initials: AM
authors.lastname: Giron
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ruano
mesh_terms: D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D005332:Fetoscopy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D001748:Urinary Bladder Neck Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*