{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T21:44:51Z","timestamp":1780350291681,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2012,8,24]],"date-time":"2012-08-24T00:00:00Z","timestamp":1345766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Malin G, Tonks A, Morris R, Gardosi J, Kilby M. Congenital lower urinary tract obstruction: a population\u2010based epidemiological study. BJOG 2012;119:1455\u20131464.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To determine the prevalence and outcome of lower urinary tract obstruction (LUTO), including the sensitivity of antenatal diagnosis.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> A retrospective population\u2010based study.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> Regional population\u2010based congenital anomalies register (WMCAR).<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> Fetuses affected by LUTO delivered between 1995 and 2007 to women resident in the West Midlands.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Cases were selected from the WMCAR using codes and keyword terms from the International Classification of Diseases, tenth revision (ICD10). Diagnoses were validated using additional data sets from Regional Fetal Medicine, Perinatal Pathology and Paediatric services.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Rates of prevalence, prenatal diagnosis and mortality, with trends.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> There were 284 LUTO cases in 851<jats:italic>\u2003<\/jats:italic>419 births during the study period, representing a total prevalence of 3.34 (2.95<jats:italic>\u2013<\/jats:italic>3.72) per 10<jats:italic>\u2003<\/jats:italic>000 births, and this prevalence did not change significantly over time. The prevalence of LUTO was significantly higher in Black and minority ethnic groups when compared with white Europeans (OR\u20032.38; 95%\u2003CI\u20031.87<jats:italic>\u2013<\/jats:italic>3.03), and are associated with area\u2010based deprivation measures (<jats:italic>P\u2003<\/jats:italic>&lt;\u20030.01). Of all LUTO cases, 221 (77.8%) were isolated, and the remainder were associated with other structural or chromosomal anomalies. The most common subtype was posterior urethral valves (PUVs; <jats:italic>n<\/jats:italic>\u2003=\u2003179, 63%). In total there were 211 (74.3%) cases of isolated, non\u2010female, singleton fetuses that fitted the referral criteria for <jats:italic>in\u2003utero<\/jats:italic> vesico\u2010amniotic shunting, giving a prevalence of 2.48 (2.14\u20132.81) per 10<jats:italic>\u2003<\/jats:italic>000 live births. Within this group, the prenatal diagnosis rate was 46.9% (99\/211).<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> This is the largest population\u2010based study of LUTO that has been performed to date, and provides accurate estimates for prevalence. The low prevalence and relatively low rate of antenatal detection limit the number of cases amenable to prenatal surgical intervention.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2012.03476.x","type":"journal-article","created":{"date-parts":[[2012,8,24]],"date-time":"2012-08-24T12:29:27Z","timestamp":1345811367000},"page":"1455-1464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":154,"title":["Congenital lower urinary tract obstruction: a population\u2010based epidemiological study"],"prefix":"10.1111","volume":"119","author":[{"given":"G","family":"Malin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AM","family":"Tonks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RK","family":"Morris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Gardosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MD","family":"Kilby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,8,24]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)39952-4"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1994.tb11910.x"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)32684-8"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1993.tb00734.x"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004670050035"},{"key":"e_1_2_7_7_2","first-page":"273","volume-title":"Fetal Therapy: Invasive and Transplacental","author":"Merrill DC","year":"1997"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.157.1.3898218"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1988.tb04267.x"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-0143(21)00895-8"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02500.x"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01382.x"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/pd.1074"},{"key":"e_1_2_7_14_2","volume-title":"Mortality Statistics. 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