{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:49:05Z","timestamp":1788306545466,"version":"build-2803163510"},"reference-count":31,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2019,8,9]],"date-time":"2019-08-09T00:00:00Z","timestamp":1565308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2020]]},"abstract":"<b><i>Background:<\/i><\/b> In utero therapeutic approaches for lower urinary tract obstruction (LUTO) have been developed to salvage the fetal kidney function. <b><i>Objective:<\/i><\/b> 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. <b><i>Methods:<\/i><\/b> 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. <b><i>Results:<\/i><\/b> The median follow-up was 3.6 years (0.5\u20137) for FC and 2.5 years (1.1\u20135.1) for VAS. There was no difference between FC and VAS in terms of survival (92 vs. 83%, <i>p<\/i> = 1), complication rate (74 vs. 92%, <i>p<\/i> = 0.88), or chronic kidney disease (58 vs. 50%, <i>p<\/i> = 1). The number of procedures was higher in the VAS group: 1.7 (1\u20133) versus 1.1 (1\u20132), <i>p<\/i> = 0.01. With a 30% rate of technical failure, FC added diagnostic value in 3 out of 21 cases. <b><i>Conclusions:<\/i><\/b> 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.<\/jats:p>","DOI":"10.1159\/000500569","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T17:00:31Z","timestamp":1569258031000},"page":"74-83","source":"Crossref","is-referenced-by-count":49,"title":["Fetal Cystoscopy and Vesicoamniotic Shunting in Lower Urinary Tract Obstruction: Long-Term Outcome and Current Technical 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