Fetal Genitourinary Diseases and Bladder Outlet Obstruction: Fetal...

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, though many approaches have been tried with limited predictive ability

Neonates with bladder outlet obstruction who survived birth and early infancy historically had no opportunity for additional treatment beyond that period

Many children with bladder outlet obstruction who survived fetal life would die of end-stage renal disease in infancy

For bladder outlet obstruction patients with normal amniotic fluid at evaluation, the historical approach has been observation regarding treatment

Fetuses with bladder outlet obstruction and normal fluid are delivered close to term to avoid complicating prematurity

For bladder outlet obstruction with abnormal fluid at evaluation, the approach includes evaluating renal fluid production and quality, preparing for chronic medical care, and restoring fluid to normal levels if chosen by the family

Management of bladder outlet obstruction requires a multidisciplinary team including neonatologists, urologists, transplant surgeons, and nephrologists

There is now a growing population of adult survivors of bladder outlet obstruction that requires ongoing care

The area of preparing families and children with normal fluid bladder outlet obstruction for chronic medical care is probably most rapidly expanding

The historical paradigm for bladder outlet obstruction provides language and perspective for counseling families about other genitourinary diseases such as cloaca in females