Case Report and Review: Prenatal Diagnosis of Congenital Megalourethra

Promsonthi, Patama; Viseshsindh, Wit

doi:10.1159/000316929

Cited by 13 publications

(15 citation statements)

References 44 publications

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“…Since the first case report of prenatal diagnosis of CM in 1989 [7], only a few more cases have been reported [8,9,10,11,12,13,14]. Recently, Amsalem et al [2] published the largest series reported so far with this condition.…”

Section: Discussionmentioning

confidence: 99%

Successful Fetoscopic Surgery to Release a Complete Obstruction of the Urethral Meatus in a Case of Congenital Megalourethra

et al. 2015

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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 megalourethra.

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Section: Discussionmentioning

confidence: 99%

Successful Fetoscopic Surgery to Release a Complete Obstruction of the Urethral Meatus in a Case of Congenital Megalourethra

et al. 2015

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“…A prenatal diagnosis of congenital megalourethra was almost made by the ultrasonographic demonstration of a ballooning of the penis [2,3]. There is only one case report that was prenatally diagnosed by use of both ultrasonography and fetoscopy at first trimester [4].…”

Section: Discussionmentioning

confidence: 99%

Fetoscopic Diagnosis of Congenital Megalourethra at Early Second Trimester

et al. 2013

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Congenital megalourethra is a rare urogenital malformation that is usually associated with lower urinary tract obstruction. In association with hypoplasia or deficiency of the corpus spongiosa and/or corpus cavernosum, a cystic dilatation of penile urethra is generally observed. We present a case of congenital megalourethra diagnosed by fetoscopy and ultrasonography at 17 weeks of gestation. Fetoscopic investigation demonstrated a balloon dilatation of the penis with a complete obstruction of the urethral meatus, which could distinguish a fusiform type congenital megalourethra from other disorders. Autopsy subsequent to the termination of pregnancy revealed a complete deficit of both corpus spongiosa and corpus cavernosum.

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“…The most common nongenitourinary organ system abnormalities associated with megalourethra are anal imperforation and anal atresia (Promosonthi and Viseshsindh, 2010), both seen in the index case. In the case described by Wu et al (1995), the finding of a malrotated colon with imperforate anus resembles the index case, but the case mentioned was predominantly a PBS, which the index case was not.…”

Section: Discussionmentioning

confidence: 99%