Success and timing of urethral endoscopies in congenital lower urinary tract obstruction (cLUTO) patients after early versus late vesicoamniotic shunting (VAS)

BACKGROUND: Fetal intervention via vesicoamniotic shunt (VAS) in congenital lower urinary tract obstruction (cLUTO) aims to improve survival and mitigate pulmonary hypoplasia. Today, early VAS is increasingly utilized to preserve renal function. However, appropriate patient selection, VAS-associated complications and long-term management remain challenging. OBJECTIVE: To investigate surgical management of the urethra and its outcome in cLUTO patients with early and late VAS. METHODS: We performed a single-center retrospective cohort study in cLUTO patients with prenatal intervention between 01/2017 and 12/2022. RESULTS: VAS was performed in 42 patients, of which 21 received early VAS at