Transient Urinary Ascites after Vesicocentesis Observed in a Fetus with Megacystis Caused by Posterior Urethral Valve

Abstract

Background: Fetal urinary ascites is a condition that is rarely encountered. A review of previous reports suggests that the clinical course of the affected fetuses is highly variable. Methods: In this report, we describe a case in which urinary ascites was observed after vesicocentesis in a fetus with megacystis caused by posterior urethral valve. Results: The urinary ascites was transient, and the fetal outcome was good after a successful vesicoamniotic shunting operation. Conclusions: In utero bladder rupture or injury and the subsequent appearance of urinary ascites may be well tolerated by the fetus. Further, spontaneous resolution can be expected during fetal life; therefore, it appears to be preferable to opt for conservative management in fetuses with urinary ascites. Urinary ascites, particularly after vesicocentesis, should be observed with extreme caution.

Peritoneal‐amniotic shunt in management of urinary ascites complicating fetal lower urinary tract obstruction

“…The Harrison shunt has been associated with a higher displacement rate 6 . UA results from spontaneous rupture of the bladder 7 , perforation after vesicocentesis 8 or VAS 9 . UA may be temporary, resolving within 2 weeks 10 ; however, if the perforation fails to heal, it limits the ability to place a VAS due to decompression of the fetal bladder and increased risk of deployment of the outer coil of the shunt into the fetal peritoneal space instead of the amniotic cavity.…”