Laser Ablation of Posterior Urethral Valves by Fetal Cystoscopy

2015 ◽  
Vol 37 (4) ◽  
pp. 267-273 ◽  
Author(s):  
José María Martínez ◽  
Narcis Masoller ◽  
Roland Devlieger ◽  
Esther Passchyn ◽  
Olga Gómez ◽  
...  
Keyword(s):  
Renal Failure ◽  
Laser Ablation ◽  
Amniotic Fluid ◽  
Gestational Age ◽  
Significant Risk ◽  
Operation Time ◽  
Posterior Urethral Valves ◽  
Consecutive Series ◽  
Urethral Valves ◽  
Median Operation Time

Objective: To report the results of fetal cystoscopic laser ablation of posterior urethral valves (PUV) in a consecutive series in two referral centers. Methods: Twenty pregnant women with a presumptive isolated PUV were treated with fetal cystoscopy under local anesthesia. Identification and fulguration of the PUV by one or several firing-contacts with diode laser were attempted. Perinatal and long-term outcomes were prospectively recorded. Results: The median gestational age at procedure was 18.1 weeks (range 15.0-25.6), and median operation time was 24 min (range 15-40). Access to the urethra was achieved in 19/20 (95%) cases, and postoperative, normalization of bladder size and amniotic fluid was observed in 16/20 (80%). Overall, there were 9 (45%) terminations of pregnancy and 11 women (55%) delivered a liveborn baby at a mean gestational age of 37.3 (29.1-40.2) weeks. No infants developed pulmonary hypoplasia and all were alive at 15-110 months. Eight (40% of all fetuses, 72.7% of newborns) had normal renal function and 3 (27.3%) had renal failure awaiting renal transplantation. Conclusion: Fetoscopic laser ablation for PUV can achieve bladder decompression and amniotic fluid normalization with a single procedure in selected cases with anyhydramnios. There is still a significant risk of progression to renal failure pre or postnatally.

scholarly journals Posterior urethral valves: Risk factors for progression to renal failure

2016 ◽  
Vol 12 (3) ◽  
pp. 179.e1-179.e7 ◽  
Author(s):  
Aylin N. Bilgutay ◽  
David R. Roth ◽  
Edmond T. Gonzales ◽  
Nicolette Janzen ◽  
Wei Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Posterior Urethral Valves ◽  
Urethral Valves

scholarly journals Comparison of the amniotic fluid and fetal urine peptidome for biomarker discovery in renal developmental disease

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Camille Fédou ◽  
Benjamin Breuil ◽  
Igor Golovko ◽  
Stéphane Decramer ◽  
Pedro Magalhães ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Biomarker Discovery ◽  
Posterior Urethral Valves ◽  
Proof Of Concept ◽  
Renal Survival ◽  
Third Trimester ◽  
Urethral Valves ◽  
Endogenous Peptides ◽  
The Third ◽  
Fetal Urine

AbstractProduction of amniotic fluid (AF) is view as predominately driven by excretion of fetal urine (FU). However, the origin of AF peptides, often considered as potential biomarkers of developmental diseases, has never been investigated. Here, we evaluated the FU origin of AF peptides and if the AF peptide content can be used as a surrogate of FU. The abundance of endogenous peptides was analyzed by capillary electrophoresis coupled to mass spectrometry in 216 AF and 64 FU samples. A total of 2668 and 3257 peptides was found in AF and FU respectively. The AF peptidome largely overlapped with the FU peptidome, ranging from 54% in the second pregnancy trimester to 65% in the third trimester. Examination of a subset of 16 paired AF and FU samples revealed that 67 peptides displayed a significant positively correlated abundance in AF and FU, strongly suggesting that their presence in AF was directly associated to FU excretion. As proof-of-concept we showed that measuring the AF abundance of these 67 peptides of FU origin allowed prediction of postnatal renal survival in fetuses with posterior urethral valves. These results demonstrate that the AF peptidome can be considered as a good surrogate of the FU peptidome.

Amniotic Fluid α-Fetoprotein in Fetal Obstructive Uropathy

PEDIATRICS ◽  
1980 ◽  
Vol 66 (4) ◽  
pp. 537-539
Author(s):  
William M. Dean ◽  
Emory J. Bourdeau
Keyword(s):  
Amniotic Fluid ◽  
Congenital Anomalies ◽  
Obstructive Uropathy ◽  
In Utero ◽  
Posterior Urethral Valves ◽  
Urinary Obstruction ◽  
Type I ◽  
Urethral Valves

Amniotic fluid α-fetoprotein has been associated with various congenital anomalies. A diagnosis in utero of urinary obstruction associated with elevated α-fetoprotein is reported. Subsequent fulguration of type I posterior urethral valves was done. A possible mechanism for elevated α-fetoprotein with obstructive uropathy in utero is discussed.

scholarly journals Urological fistulas after fetal cystoscopic laser ablation of posterior urethral valves: surgical technical aspects

2015 ◽  
Vol 45 (2) ◽  
pp. 183-189 ◽  
Author(s):  
N. Sananes ◽  
R. Favre ◽  
C. J. Koh ◽  
A. Zaloszyc ◽  
M. C. Braun ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Posterior Urethral Valves ◽  
Technical Aspects ◽  
Urethral Valves ◽  
Surgical Technical

scholarly journals Posterior Urethral Valves, Balanitis and Acute Renal Failure: Any Link?

2018 ◽  
Vol 4 (1) ◽  
Author(s):  
Termos S ◽  
Alkabbani M ◽  
Alali M ◽  
AlSaleh A ◽  
Sanjad S ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Posterior Urethral Valves ◽  
Urethral Valves

Endocrinology

2017 ◽  
Author(s):  
Grenville Fox ◽  
Nicholas Hoque ◽  
Timothy Watts
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Posterior Urethral Valves ◽  
Background Information ◽  
Renal Development ◽  
Polycystic Kidney ◽  
Renal Anomalies ◽  
Urethral Valves ◽  
And Function ◽  
Renal Pelvis Dilatation

This chapter provides background information on fetal and neonatal renal development, physiology, and function. Detailed information is given on management of common, antenatally diagnosed, renal anomalies (renal pelvis dilatation/hydronephrosis); post-natal diagnoses (hypospadius, hydrocele); posterior urethral valves; polycystic kidney disease; and rarer diagnoses. There is a guideline on the management of acute renal failure in the newborn, and information on dialysis.

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