Pressure-limited vesico-amniotic shunt tube for fetal obstructive uropathy.

Introduction: In utero shunting (vesico-amniotic shunt) of obstructive uropathy in fetal lambs produces a shrunken, noncompliant bladder. We hypothesized that using a ventriculo-peritoneal shunt for the vesico-amniotic shunt may preserve the filling/emptying cycle and thus normal bladder development.

Materials And Methods: We created obstructive uropathy in 60-day gestation fetal lambs, ligating the urethra and urachus.

Early bladder wall changes after creation of obstructive uropathy in the fetal lamb.

Vesico-amniotic shunting of obstructive uropathy in fetal lambs produced a thick-walled, poorly compliant bladder. We report the early histological changes in the obstructed bladder wall. We created an obstructive uropathy in fetal lambs at 60 days gestation by ligating the urethra and urachus.

Vesicoamniotic shunt for complete urinary tract obstruction is partially effective.

Purpose: The long-term outcome for children after antenatal intervention for obstructive uropathies is disappointing. We reported that renal dysplastic changes are well established 3 weeks after obstruction in a fetal lamb model. We used this model to explore renal development and bladder function after fetal intervention.

Effects of early vesicostomy in obstructive uropathy on bladder development.

Purpose: Creation of a vesico-amniotic shunt for obstructive uropathy removes the normal fetal urination cycle. It is unclear how this affects bladder function at term. The authors measured the bladder volume and reviewed the bladder histology after fetal vesicostomy.

The early effects of urinary tract obstruction on glomerulogenesis.

Purpose: Our obstructive uropathy model in fetal lambs showed that renal cystic changes appeared 3 weeks after obstruction. In this study, the authors investigated the changes resulting from complete urinary tract obstruction in the first 7 days after obstruction.

Methods: An obstructive uropathy was created in fetal lambs at 60 days' gestation by ligating the urethra and urachus.

Fetal hydrops in experimental obstructive uropathy resolves after vesicostomy formation: is this cause and effect?

The association of obstructive uropathy and hydrops is rare but often fatal. Hydrops has been observed in our fetal lamb model with obstructive uropathy. We created a vesicoamniotic shunt 21 days after creating the obstruction to explore the effect of relieving the obstruction on the hydrops.

Six cases of children with a benign cervical tumor who required tracheostomy.

Cervical tumors sometimes cause airway obstruction. We have treated six children with benign cervical tumors who required tracheostomy. Two cervical and one glossal lymphangiomata treated with local injection of OK432 after creating a tracheostomy were successfully decannulated after the treatment.

Optimal timing of prenatal treatment of obstructive uropathy in the fetal lamb.

Purpose: It was still unclear how urinary tract obstruction alters normal nephrogenesis and leads to renal dysplasia. The authors created an obstructive uropathy model in fetal lambs and reviewed the pathology of the obstructed kidney to determine the optimal timing for decompression of the obstruction.

Methods: Obstructive uropathy was created in fetal lambs at 60 days' gestation by ligating the urethra and urachus.

Successful resection of prostatic rhabdomyosarcoma by the posterior sagittal approach combined with preoperative chemotherapy.

The authors used a posterior sagittal approach to successfully remove a huge prostatic rhabdomyosarcoma from a 3-year-old boy after he had received intensive chemotherapy. This procedure enables safe removal of the prostatic rhabdomyosarcoma under direct vision and with minimal damage to other pelvic organs.