2025 Volume 61 Issue 1 Pages 147-151
Lower urinary tract obstruction（LUTO）with oligohydramnios causes pulmonary hypoplasia, which is associated with high mortality rates. Even if a patient survives, renal and bladder dysfunction remains a long-term issue. Herein, we report the case of a neonate with an anterior urethral valve（AUV）, and diverticulum with significant bladder dysfunction after birth, despite the absence of oligohydramnios. At 28 weeks of gestation, a male fetus was noted to have bilateral hydronephrosis, hydroureter, and keyhole signs on prenatal ultrasound. LUTO was suspected, but the amniotic fluid volume was maintained. One day after a full-term birth, urethral diverticulum and AUV were suspected due to an inguinal mass. Although his urine output was sufficient, overflow incontinence was observed, and percutaneous vesicostomy was performed on day 3 of life because of bladder hypertrophy and worsening hydronephrosis. The hydronephrosis did not improve after the procedure, and the patient developed urinary tract infections shortly after discharge. In cases of LUTO without oligohydramnios, there is no indication for fetal therapy or early delivery. However, the present case demonstrates that, even without oligohydramnios, severe bladder dysfunction can develop from intermittent occlusion with increased pressure in the bladder in utero, emphasizing the need for caution.
