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首页> 外文期刊>Fetal diagnosis and therapy >Successful Fetoscopic Surgery to Release a Complete Obstruction of the Urethral Meatus in a Case of Congenital Megalourethra
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Successful Fetoscopic Surgery to Release a Complete Obstruction of the Urethral Meatus in a Case of Congenital Megalourethra

机译：成功的胎儿镜手术可在先天性大尿道口病例中完全释放尿道口阻塞

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We report the successful use of fetoscopy to treat a case of severe low urinary tract obstruction (LUTO) secondary to a congenital megalourethra. A second trimester male fetus presented at 21 weeks of gestation with massive dilatation of the penile urethra. In addition, bilateral hydronephrosis, an enlarged and hypertrophic bladder, with progressive oligohydramnios were found, suggesting poor prognosis. Extensive counselling was performed and, after the approval from the local ethics committee and informed consent, patients accepted fetal therapy by fetoscopy. The procedure consisted in fetoscopic identification of the tip of the penis and confirmation of the complete absence of the urethral meatus. Thereafter, under combined endoscopic and ultrasound guidance a perforation of the tip of the penis was performed with contact diode laser, until an opening into the urethra was achieved. After the operation, resolution of the cystic penile dilation, with reduction of the penile size, and normalization of the amniotic fluid volume were observed. The pregnancy continued uneventfully and a normal male infant was born at term at the local hospital. The baby was developing normally with normal renal function at 6 months of age. Our report demonstrates that fetoscopic decompression of a distal urethra obstruction can achieve neonatal survival in the rare event of congenital nnegalourethra. (C) 2015 S. Karger AG, Basel
机译：我们报告成功地使用了子宫镜检查来治疗继发于先天性半尿道炎的严重低尿路梗阻（LUTO）。妊娠中期21个月的男性胎儿出现阴茎尿道大量扩张。此外，发现双侧肾积水，膀胱肥大，伴进行性羊水过少，提示预后不良。进行了广泛的咨询，在获得当地伦理委员会的批准并获得知情同意后，患者接受了通过胎儿镜检查进行胎儿治疗。该程序包括用阴茎镜检查阴茎尖，并确认完全没有尿道口。此后，在内窥镜和超声的联合指导下，用接触二极管激光对阴茎的尖端进行穿孔，直到通入尿道。手术后，观察到囊性阴茎扩张的消退，阴茎大小的减小以及羊水量的正常化。妊娠继续顺利进行，足月男婴在当地医院出生。婴儿在6个月大时发育正常，肾功能正常。我们的报告表明，在罕见的先天性尿道炎事件中，通过镜下远端尿道梗阻减压可以实现新生儿生存。 （C）2015 S.Karger AG，巴塞尔

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