Fetal Genitourinary Diseases and Bladder Outlet Obstruction: Fetal...
With Dr. Todd Ponsky · StayCurrentMD
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Bladder outlet obstruction provides a language and framework for coaching conversations about other genitourinary diseases such as cloaca in the female
50% of fetuses with bladder outlet obstruction will survive to birth with therapy
50% of fetuses with bladder outlet obstruction that survive to live birth will survive infancy and childhood
There are no good predictors of survival for fetuses with bladder outlet obstruction
Many predictive methods have been tried but work with limited ability to predict which fetuses will survive into childhood
Prior to current options, neonates that survived birth and early infancy had no opportunity for additional treatment beyond that period
Many children with bladder outlet obstruction that made it through fetal life would die of end-stage renal disease in infancy
For bladder outlet obstruction patients with normal fluid at evaluation, historical management has been observation regarding treatment
Patients with bladder outlet obstruction and normal fluid are delivered close to term because complicating prematurity would be an additional challenge for the child to make it out of the nursery
For bladder outlet obstruction patients with abnormal fluid at evaluation, management includes evaluating renal fluid production and quality of the fluid
Restoring fluid to normal levels is an intervention option chosen by the family for bladder outlet obstruction cases with abnormal fluid
A multidisciplinary team including neonatologists, urologists, transplant surgeons, and nephrologists is needed for bladder outlet obstruction care
Preparation for chronic medical care of bladder outlet obstruction patients now includes preparing the mother, father, and rest of the family
There is a growing population of adult survivors of bladder outlet obstruction requiring continuity of care
Survivors of bladder outlet obstruction have diseases of the lungs, kidneys, and bladders requiring a multidisciplinary team of neonatologists, pulmonologists, urologists, nephrologists, and transplant surgeons