CONGENITAL URINARY BLADDER OUTLET OBSTRUCTION

2010 ◽  
Vol 21 (1) ◽  
pp. 55-73 ◽  
Author(s):  
MARIE-KLAIRE FARRUGIA ◽  
ADRIAN S WOOLF
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Clinical Manifestations ◽  
Outlet Obstruction ◽  
Bladder Disease ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

The term congenital ‘bladder outlet obstruction (BOO)’ describes the collection of conditions in which the normal, urethral egress of urine from the fetal bladder is impaired. The term is interchangeable with fetal ‘lower urinary tract obstruction’, as used by other authors. After considering normal urinary tract embryology, we describe the epidemiology of congenital BOO and the primary anatomical disorders associated with it. We then proceed to describe its fetal and postnatal clinical manifestations and then consider therapies and interventions which have been used to manage the condition. We not only focus on urethral and bladder disease with constitutes BOO itself, but also describe associated kidney disorders which, via chronic renal excretory failure, are important causes of morbidity. Rather than provide an exhaustive review, we emphasise studies published in the last decade, and therefore readers are referred to other reviews citing numerous earlier references.

scholarly journals Lower urinary tract obstruction in male children–a report of three cases.

2016 ◽  
Vol 18 (3) ◽  
pp. 400 ◽  
Author(s):  
Donboklang Lynser ◽  
Evarisalin Marbaniang ◽  
Pynskhemboklang Khongsni
Keyword(s):  
Urinary Tract ◽  
Bladder Outlet Obstruction ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Outlet Obstruction ◽  
Posterior Urethral Valve ◽  
Urethral Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Urethral Valve ◽  
Lower Urinary

Urinary retention in young children and infancy is relatively rare. The commonest malignancy cause of bladder outlet obstruction in infancy is prostatic rhabdomyosarcoma; the commonest cause of congenital bladder outlet obstruction in a male infantis posterior urethral valve and the commonest cause of urethral obstruction in male children is urethral calculi. We present here a report on three cases of urethral obstruction in male children. 

scholarly journals Postnatal Management in Congenital Lower Urinary Tract Obstruction With and Without Prenatal Vesicoamniotic Shunt

2021 ◽  
Vol 9 ◽  
Author(s):  
Marietta Jank ◽  
Raimund Stein ◽  
Nina Younsi
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Outlet Obstruction ◽  
Early Management ◽  
Postnatal Management ◽  
Urinary Drainage ◽  
Lower Urinary Tract Obstruction ◽  
Vesicoamniotic Shunt ◽  
Lower Urinary

Purpose: Congenital lower urinary tract obstruction (cLUTO) includes a heterogeneous group of conditions caused by a functional or mechanical outlet obstruction. Early vesicoamniotic shunting (VAS) possibly reduces the burden of renal impairment. Postpartum, pediatric urologists are confronted with neonates who have a shunt in place and a potentially impassable urethra with a narrow caliber. Early management of these patients can be challenging. Here, we would like to share the approach we have developed over time.Materials and Methods: We conducted a single-center retrospective analysis from 2016 to 2020 and included all patients diagnosed with cLUTO. Data focusing on time point and type of intervention was collected. Furthermore, patients with temporary diversion via a percutaneous VAS were selected for a more detailed review.Results: In total, 71 cases of cLUTO were identified during the study period. Within this group, 31 neonates received postnatal management and surgical intervention in our center. VAS was performed in 55% of these cases (N = 17). The postnatal treatment varied between transurethral or suprapubic catheterization and early Blocksom vesicostomy. In five infants with VAS, the urinary drainage was secured through the existing VAS by inserting a gastric tube (N = 1) or a 4.8 Fr JJ-stent (N = 4). To our knowledge, this is the first report of a stent-in-stent scheme, which can remain indwelling until the definite treatment.Conclusion: Having a secure urine drainage through a VAS allows the often premature infant to grow until definite surgery can be performed. This avoids placing a vesicostomy, which requires anesthesia.

scholarly journals A higher level of prostaglandin E2 in the urinary bladder in young boys and boys with lower urinary tract obstruction

2009 ◽  
Vol 30 (6) ◽  
pp. 343-347 ◽  
Author(s):  
Katsuya Aoki ◽  
Akihide Hirayama ◽  
Nobumichi Tanaka ◽  
Tatsuo Yoneda ◽  
Katsunori Yoshida ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Bladder ◽  
Prostaglandin E2 ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

Myokardiale Funktion bei Feten mit Lower Urinary Tract Obstruction

2018 ◽  
Author(s):  
O Graupner ◽  
C Enzensberger ◽  
M Götte ◽  
A Wolter ◽  
V Müller ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Lower Urinary Tract Obstruction ◽  
Lower Urinary

Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

2021 ◽  
pp. 1-13
Author(s):  
R. Douglas Wilson ◽  
Gregg Nelson
Keyword(s):  
Quality Improvement ◽  
Urinary Tract ◽  
Lower Urinary Tract ◽  
Urinary Tract Obstruction ◽  
Fetal Surgery ◽  
Fetal Therapy ◽  
Lower Urinary Tract Obstruction ◽  
Evidenced Based ◽  
Process Elements ◽  
Lower Urinary

<b><i>Background:</i></b> Pregnancies that are prenatally identified to have fetal anomalies are complex and require expert multidisciplinary care. As many conditions can impact the fetus prenatally and require intervention, an enhanced recovery after surgery (ERAS) for lower urinary tract obstruction (LUTO) is being evaluated to determine the level of evidenced-based data available. <b><i>Problem:</i></b> The percutaneous ultrasound-guided fetal surgery procedure for bladder neck obstruction is the focus for elements of preoperative counseling, intraoperative procedure/risk complications, and postoperative management. <b><i>Methods:</i></b> A quality improvement review Squire 2.0 (2000–2020) was undertaken for the percutaneous LUTO fetal surgery shunting (lower urinary tract obstruction), process and procedure which require 2 process pathways, one to evaluate the fetal candidate and a second to treat. This structured review is focused on identifying the process elements to allow the determination of the number of evidenced-based elements that would allow for audit and measurement of the clinical element variance for comparative feedback to the individual surgical provider or surgery center. <b><i>Interventions:</i></b> Titles and abstracts were screened to identify potentially relevant articles with priority given to meta-analyses, systematic reviews, randomized controlled studies, nonrandomized controlled studies, reviews, and case series. <b><i>Results:</i></b> A series of potential clinical elements for the diagnostic fetal evaluation and for the 3 protocol areas of surgical care for the procedures (pre-, intra-, and postoperative care) are identified using an ERAS-like process. <b><i>Conclusions:</i></b> The identified clinical elements have the potential for ERAS-LUTO fetal therapy guideline. Multidisciplinary collaboration (surgeon, anesthesia, nursing, imaging, and laboratory) is required for ERAS quality improvement in the pre-, intra-, and postoperative processes. Process elements in each of the operative areas can be audited, evaluated, compared, and modified/improved.

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