%0 Generic
%A N., Vinit
%A A., Gueneuc
%A B., Bessières
%A S., Dreux
%A L., Heidet
%A R., Salomon
%A A., Lapillonne
%A G., DeBernardis
%A L.J., Salomon
%A J.J., Stirnemann
%A T., Blanc
%A Y., Ville
%D 2019
%T Supplementary Material for: Fetal Cystoscopy and Vesicoamniotic Shunting in Lower Urinary Tract Obstruction: Long-Term Outcome and Current Technical Limitations
%U https://karger.figshare.com/articles/dataset/Supplementary_Material_for_Fetal_Cystoscopy_and_Vesicoamniotic_Shunting_in_Lower_Urinary_Tract_Obstruction_Long-Term_Outcome_and_Current_Technical_Limitations/9423395
%R 10.6084/m9.figshare.9423395.v1
%2 https://karger.figshare.com/ndownloader/files/17044235
%K Fetal surgery
%K Lower urinary tract obstruction
%K Fetal cystoscopy
%K Vesicoamniotic shunting
%K Posterior urethral valve
%X Background: In utero therapeutic approaches for lower urinary tract obstruction (LUTO) have been developed to salvage the fetal kidney function. Objective: The aim of this work was to report the long-term survival, nephrological, and urological outcome of children treated prenatally for LUTO using operative fetal cystoscopy (FC) and vesicoamniotic shunting (VAS) or both. Methods: A retrospective study of 48 procedures (23 FC, 25 VAS) was performed on 33 patients (between 2008 and 2018). Reviewed data included prenatal management and clinical follow-up by a pediatric nephrologist and a pediatric urologist. Both intention-to-treat and per-protocol analyses were conducted. Results: The median follow-up was 3.6 years (0.5–7) for FC and 2.5 years (1.1–5.1) for VAS. There was no difference between FC and VAS in terms of survival (92 vs. 83%, p = 1), complication rate (74 vs. 92%, p = 0.88), or chronic kidney disease (58 vs. 50%, p = 1). The number of procedures was higher in the VAS group: 1.7 (1–3) versus 1.1 (1–2), p = 0.01. With a 30% rate of technical failure, FC added diagnostic value in 3 out of 21 cases. Conclusions: No difference was found between FC and VAS regarding survival, long-term kidney function, or urological outcome. Despite overly optimistic reports on FC, it lacks reproducibility due to posterior-urethra inadequate visualization and inappropriate instrumentation.
%I Karger Publishers