Experimental congenital obstructive uropathy.

Continued experimental work in congenital obstructive uropathy is essential to support the rapidly advancing field of fetal medicine. It is possible to reproduce the clinically relevant obstructive lesions in an experimental model. On the basis of data from these models, the tentative conclusion is that in utero intervention is beneficial in severe congenital obstructive uropathy associated with oligohydramnios. The limited human experience provides insufficient data to confirm this hypothesis but has demonstrated the technical feasibility of prenatal interventions. There is a critical need for further refinement in understanding the complex pathophysiology of congenital obstructive uropathy, not only the renal consequences, but also the pulmonary and systemic effects. There remains the particular need to resolve the determinants and indicators of functional salvageability of the kidneys and lungs in congenital obstructive uropathy.