Objectives: To report our experience with cystoscopic laser ablation for the prenatal treatment of posterior urethral valves (PUV). Methods: Twenty pregnant women with a presumptive isolated PUV were treated with fetal cystoscopy under local anesthesia. Identification and fulguration of the PUV by firing-contacts with diode laser was attempted in two experienced fetal therapy units. Perinatal and long-term outcomes were prospectively recorded. Results: Median gestational age at procedure was 18.1 weeks (range 15.0-25.6). Access to the urethra was achieved in 19/20 (95%) cases with a median operation time of 24 minutes (range 15-40). After surgery, normalization of bladder size and amniotic fluid was observed in 16/20 (80%). After treatment, 9 cases (45%) opted for terminations of pregnancy and 11 (55%) delivered a liveborn baby at a mean gestational age of 37.3 (29.1-40.2) weeks. No infants developed pulmonary hypoplasia and all are alive at 11-106 months. Eight (40% of all fetuses, 72.7% of newborns) have normal renal function and 3 (27.3%) have renal failure awaiting renal transplantation. Conclusions: Fetoscopic laser ablation for selected cases of PUV can be a life-saving single procedure by achieving normalization of amniotic fluid. In spite of technical success, the possible benefit in avoiding progression to renal failure pre or postnatally remains to be elucidated.Objectives: The shortage of highly trained sonographers worldwide limits the wider adoption of ultrasound (US) as a diagnostic tool in obstetrics. The aim of this study was to develop a learning software
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