A new minimally invasive technique for cystoscopic laser treatment of fetal ureterocele

Prenatal ultrasound detection of fetal ureterocele with bilateral hydro-ureteronephrosis, obstruction of the bladder outlet and progressive amniotic fluid reduction can be associated with a significant risk of end-stage chronic renal disease after birth. Fetal cystoscopic laser incision of the ureterocele, with the aim of relieving the bladder outflow obstruction to preserve renal function, has been previously reported in one case, with a favourable outcome. This report employed standard 3.5-mm fetoscopic access to the amniotic cavity and the fetal bladder. We report on two additional cases of fetal ureterocele treated by cystoscopic laser decompression. in the first case a standard 3.3-mm uterine entry was used. For the second case, a new approach was adopted using an all-seeing-needle 1.6-mm endoscope.