A lower urinary tract obstruction (LUTO) occurs in utero when the flow of urine is blocked from exiting the body at the level of the lower urinary tract, which is comprised of the bladder and urethra. When this occurs, all parts of the urinary tract that lie above the obstruction may become distended with urine that cannot drain. Over time, severe blockage can lead to permanent kidney damage in the fetus. When urine can no longer be excreted, the fluid around the fetus (amniotic fluid) decreases. This can lead to lung damage because the fetus must move the amniotic fluid in and out of the lungs for them to develop normally. Therefore, LUTO can lead to damage in more than one organ system.
Lower Urinary Tract Obstruction: Why Choose Johns Hopkins
- As innovators in fetal surveillance techniques, we offer diagnostic micro-cystoscopy for the early identification of lower urinary tract obstruction.
- The goal of fetal treatment for LUTO is to provide constant drainage of urine from the body into the amniotic fluid in order to avoid buildup of urine and to normalize amniotic fluid volume.
- At the Center for Fetal Therapy, we offer several treatments for LUTO, including vesicocentesis, vesicoamniotic shunt placement, and operative fetal cystoscopy for posterior urethral valves and urethral stenosis.
- After treatment for LUTO, our patients will have continued access to the most advanced multidisciplinary care at Johns Hopkins, including our fetal, maternal and pediatric specialties, as well as our neonatal intensive care unit (NICU). The NICU can perform more testing after birth to figure out the cause of the LUTO or to look for other birth defects or medical problems.
Rely on the expertise of our physicians to help you treat and manage a lower urinary tract obstruction.
Joint Appointment in Surgery
Director, Center for Fetal Therapy
Assistant Professor of Surgery