{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:02:04Z","timestamp":1779840124694,"version":"3.53.1"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"abstract":"ABSTRACT<\/jats:title>\n The recent use of Somatex shunts in the prenatal drainage of megacystis\n remains poorly documented. Here, we describe a number of complications\n affecting the cutaneous and muscular tissues that have not been reported to\n date.<\/jats:p>\n The records of all male patients born alive after receiving a vesicoamniotic\n shunt were studied retrospectively. The primary end point was the presence\n of a cutaneous partially muscular lesion at birth. In addition, we analyzed\n the impact of shunt placement timing on the occurrence of these\n injuries.<\/jats:p>\n Thirty patients were included. Seven patients received a Harrison fetal\n bladder stent, and none of them had skin ulceration visible at birth. Among\n the 23 patients who received a Somatex shunt, we observed ulcerative lesions\n of the lower limbs in 12 patients, representing 52% of children. In these\n patients, a single lesion was found, except for one case showing affected\n tissues on both lower limbs. Seventeen of these Somatex shunts were placed\n in the first 17 weeks of gestation. Among them, 10 showed ulcerative lesions\n whereas among the 6 Somatex shunts inserted later in pregnancy, two patients\n had an ulcerative skin lesion. There was no statistically significant\n difference in the occurrence of skin lesions between these two groups (10\/17\n vs. 2\/6, p\u2009=\u20090.37).<\/jats:p>\n The implantation of Somatex shunts in the prenatal treatment of megacystis is\n associated with cutaneous and muscular lesions in more than half of the\n newborns. Our results underline the importance of antenatal advice prior to\n the implantation of these shunts, regarding also the esthetic consequences\n of these lesions.<\/jats:p>","DOI":"10.1055\/a-2873-3543","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:03:07Z","timestamp":1779836587000},"source":"Crossref","is-referenced-by-count":0,"title":["Intrauterine Ulceration of the Lower Limbs: A Not-so-rare\n Complication Following Vesicoamniotic Shunting with Somatex"],"prefix":"10.1055","author":[{"given":"Jules","family":"Kohaut","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, NRW, Germany","place":["Cologne"],"department":["Division of Pediatric Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Pantani","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, NRW, Germany","place":["Cologne"],"department":["Division of Pediatric Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, NRW, Germany","place":["Cologne"],"department":["Division of Prenatal Medicine, Gynecological Ultrasound and Fetal\n Surgery, Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6240-2417","authenticated-orcid":false,"given":"Janina","family":"Fischer-Mertens","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, NRW, Germany","place":["Cologne"],"department":["Division of Pediatric Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"D\u00fcbbers","sequence":"additional","affiliation":[{"name":"University Hospital Cologne, NRW, Germany","place":["Cologne"],"department":["Division of Pediatric Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.urology.2014.02.018","article-title":"Fetal megacystis: etiologies, management, and outcome according to the\n trimester","volume":"84","author":"L Fievet","year":"2014","journal-title":"Urology"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1002\/pd.5669","article-title":"Fetal lower urinary tract obstruction: what should we tell the prospective\n parents?","volume":"40","author":"E R Ibirogba","year":"2020","journal-title":"Prenat Diagn"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1007\/s00467-017-3815-0","article-title":"Current strategies to predict and manage sequelae of posterior urethral valves\n in children","volume":"33","author":"A V Deshpande","year":"2018","journal-title":"Pediatr Nephrol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1016\/S0022-5347(05)66174-5","article-title":"Urethral atresia: long-term outcome in 6 children who survived the neonatal\n period","volume":"165","author":"R Gonz\u00e1lez","year":"2001","journal-title":"J Urol"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1111\/j.1471-0528.2012.03476.x","article-title":"Congenital lower urinary tract obstruction: a population-based epidemiological\n study","volume":"119","author":"G Malin","year":"2012","journal-title":"BJOG"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jpurol.2015.07.012","article-title":"Current applications of in utero intervention for lower urinary tract\n obstruction","volume":"11","author":"L I Smith-Harrison","year":"2015","journal-title":"J Pediatr Urol"},{"issue":"9903","key":"ref7","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1016\/S0140-6736(13)60992-7","article-title":"Percutaneous vesicoamniotic shunting versus conservative management for fetal\n lower urinary tract obstruction (PLUTO): a randomised trial","volume":"382","author":"R K Morris","year":"2013","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jpurol.2022.01.002","article-title":"Vesico-amniotic shunt insertion prior to the completion of 16 weeks results in\n improved preservation of renal function in surviving fetuses with isolated\n severe lower urinary tract obstruction (LUTO)","volume":"18","author":"T Kohl","year":"2022","journal-title":"J Pediatr Urol"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s00404-020-05598-z","article-title":"Vesicoamniotic shunting for fetal megacystis in the first trimester with a\n Somatex\u00ae intrauterine shunt","volume":"302","author":"B Strizek","year":"2020","journal-title":"Arch Gynecol Obstet"},{"issue":"03","key":"ref10","doi-asserted-by":"crossref","first-page":"F166","DOI":"10.1136\/adc.2006.099820","article-title":"Vesicoamniotic shunting for fetal lower urinary tract obstruction: an\n overview","volume":"92","author":"R K Morris","year":"2007","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"09","key":"ref11","doi-asserted-by":"crossref","first-page":"2312","DOI":"10.3390\/jcm11092312","article-title":"Intrauterine thoracoamniotic shunting of fetal hydrothorax with the somatex\n intrauterine shunt: intrauterine course and postnatal outcome","volume":"11","author":"J Grandt","year":"2022","journal-title":"J Clin Med"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s00404-022-06905-6","article-title":"Single-center outcome analysis of 46 fetuses with megacystis after intrauterine\n vesico-amniotic shunting with the Somatex\u00aeintrauterine shunt","volume":"309","author":"I Gottschalk","year":"2024","journal-title":"Arch Gynecol Obstet"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/s00345-024-05307-4","article-title":"A new spectrum of neonatal urethral pathologies in the era of early\n vesicoamniotic shunting?","volume":"42","author":"J Kohaut","year":"2024","journal-title":"World J Urol"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"567.e1","DOI":"10.1016\/j.jpurol.2023.06.027","article-title":"Postnatal surgical treatment and complications following intrauterine\n vesicoamniotic shunting with the SOMATEX\u00ae intrauterine shunt. A single center\n experience","volume":"19","author":"J Kohaut","year":"2023","journal-title":"Pediatr Urol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1055\/a-2631-4152","article-title":"Postnatal outcomes and surgical implications of Somatex\u2122 thoracoamniotic\n shunting for CPAM: a multicenter experience","volume":"35","author":"J Kohaut","year":"2025","journal-title":"Eur J Pediatr Surg"}],"container-title":["Klinische P\u00e4diatrie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2873-3543.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T23:03:09Z","timestamp":1779836589000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2873-3543"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":15,"URL":"https:\/\/doi.org\/10.1055\/a-2873-3543","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0300-8630","1439-3824"],"issn-type":[{"value":"0300-8630","type":"print"},{"value":"1439-3824","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}