Bladder outlet obstruction is a rare condition that occurs when the urethra, the tube that carries urine from the bladder out of the body, is too narrow or obstructed. This blockage causes urine to back up in the bladder, placing an unborn baby at risk for kidney and lung problems.
- What Is Bladder Outlet Obstruction?
Bladder outlet obstruction is a rare condition that can affect the health of your fetus. It occurs when the urethra, the tube that carries urine from the bladder out of the body, becomes partially or fully obstructed. In utero, urine is unable to pass from the baby’s bladder to the surrounding amniotic sac. An unborn baby with an obstructed bladder is at risk for serious health problems, including:
- Kidney damage: The kidneys may not function properly or they may stop working altogether. After birth, some babies with BOO experience kidney failure.
- Underdeveloped lungs: When a blockage prevents urination, the level of amniotic fluid vital for fetal “breathing” can get extremely low and hinder lung development. Some babies’ lungs may be too small to promote survival after birth.
- Hydronephrosis: Bladder blockage can lead to a buildup of urine in the kidneys.
Signs of bladder outlet obstruction may be found during a routine ultrasound when an enlarged bladder, low amniotic fluid level and/or abnormal kidney appearance is observed. Bladder outlet obstruction can also be tied to other congenital and chromosomal abnormalities. For this reason, the team at Fetal Care Center Dallas uses a multidisciplinary approach to address bladder outlet obstruction and any other concerns or symptoms that may arise in connection with the condition.
- How We Treat BOO
Treatment for fetal bladder outlet obstruction depends largely on the severity and type of obstruction, as well as the gestational age of your baby. If your amniotic fluid level is normal, no treatment may be needed before your baby is born. Extremely low amniotic fluid levels can threaten your baby’s life, and may require one of the following interventions:
- Placement of a shunt, or hollow tube, in the baby’s bladder to drain fluid into the amniotic space. With shunting, urine in the bladder is able to bypass the obstruction and drain. This helps replenish amniotic fluid and promote lung development in your unborn baby.
- Fetoscopic laser treatment to remove the tissue causing the blockage.
- Placement of an amnioport to maintain the level of amniotic fluid surrounding the baby. This novel therapy allows a physician to repeatedly infuse fluid into the amniotic sac to replenish amniotic fluid throughout pregnancy.
Babies most likely to benefit from fetal surgery for bladder obstruction are those who are at risk of kidney damage and impairment of lung development, but have not yet experienced irreversible kidney damage.
Deciding which treatment option to pursue, if any, is a very personal choice. When detected early, it is reassuring to know that available treatment options can help your baby thrive both during pregnancy and after delivery. Physicians at Fetal Care Center Dallas excel in performing complex shunting and other treatment techniques to correct fetal bladder outlet obstruction and provide a healthier start for your newborn.