Fetoscopic Vesicostomy for Lower Urinary Tract Obstruction: A Proposal for a New Surgical Technique.

What's already known about this topic? ◦. Lower urinary tract obstruction (LUTO) is associated with elevated perinatal mortality and morbidity. ◦. Fetal interventions have been proposed for severe forms of LUTO, including vesicoamniotic shunt placement and fetal cystoscopy. ◦. Experimental studies suggest that fetal vesicostomy could be a valid therapeutic option especially for fetuses with LUTO associated with Prune Belly. ◦. Open fetal vesicostomy through maternal hysterotomy has been proposed, but the risk of maternal and obstetrical outcomes was not encouraging. What does this study add? ◦. We propose a new intervention consisting of fetal vesicostomy through a maternal laparotomy‐assisted fetoscopic procedure. ◦. Fetoscopic vesicostomy through maternal laparotomy is feasible and seems safe for fetuses with severe LUTO associated with Prune Belly. ◦. Fetoscopic vesicostomy may be a therapeutic alternative for fetuses with severe LUTO associated with the Prune Belly after unsuccessful vesicoamniotic shunt placements and fetal cystoscopy.