Fetal Cystoscopy and Vesicoamniotic Shunting in Lower Urinary Tract Obstruction: A Meta-Analysis of Long-Term Outcome and Current Technical Limitations
Abstract
Abstract Introduction: The aim of the study was to compare obstetrical, survival, and nephro-urological outcomes of fetuses diagnosed with lower urinary tract obstruction (LUTO) undergoing antenatal procedures by vesicoamniotic shunting (VAS) or fetal cystoscopy (FC). Methods: This study was a literature search using MEDLINE, Scopus, Embase, and Cochrane reference lists. All studies reporting VAS and FC’s effectiveness, complications, and technical issues in the prenatal treatment of LUTO were selected for a single-proportion meta-analysis. Two reviewers independently selected studies, extracted data, and assessed quality. We computed and declared effect sizes for estimating a single proportion using the Freeman-Turkey transformed proportion. Results: Out of a total of 467 citations identified, 49 studies were included for a detailed evaluation of VAS and FC perinatal outcomes. Overall, VAS and FC were burdened by a similar incidence of intrauterine fetal demise (VAS: 0.51 [0.42–0.61] vs. FC: 0.47 [0.28–0.67]; p = 0.73), postnatal death (VAS: 0.87 [0.75–0.99] vs. FC: 0.86 [0.62–1.09]; p value: 0.87), and postnatal renal impairment (VAS: 1.22 [1.06–1.39] vs. FC: 0.96 [0.67–1.25]; p value: 0.12). Likewise, the two procedures were complicated by a similar rate of chorioamnionitis (VAS: 0.38 [0.28–0.47] vs. FC: 0.39 [0.12–0.66]; p value: 0.92), premature rupture of membranes/preterm premature rupture of membranes (VAS: 0.77 [0.60–0.94] vs. FC: 0.84 [0.60–1.07]; p value: 0.65),…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.