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Updated: Nov 10, 2025
Surgical Management of Meatal Stenosis with Meatoplasty
Published on: November 30, 2010
Fetoscopic urethral meatotomy in fetuses with lower urinary tract obstruction by congenital megalourethra
Rogelio Cruz-Martínez1,2, Miguel Martínez-Rodríguez1,3, Alma Gámez-Varela1
1Prenatal Diagnosis and Fetal Surgery Center, Medicina Fetal México and Fetal Medicine Foundation of Mexico, Queretaro, México.
Background:
To describe the perinatal outcomes of fetoscopic urethral meatotomy (FUM) in fetuses with lower urinary tract obstruction (LUTO) by congenital megalourethra.
Study Design:
Between 2012 and 2020, 226 cases with LUTO were referred to our fetal surgery center in Queretaro, Mexico. We report the perinatal outcome of cases with LUTO by congenital megalourethra that were selected for FUM in an attempt to release the penile urethral obstruction.
Results:
Congenital megalourethra was diagnosed in 10 cases (4.4%) but only 3 cases (30%) with obstructive megalourethra and megacystis were selected for fetal surgery. Fetoscopic urethral metatotomy was successfully performed in all three cases at a median gestational age (GA) of 21.4 (18.0-26.7) weeks and with a median surgical time of 27 (12-43) min. A resolution of urethral dilatation and subsequent reduction of the penile length and normalization of both the bladder size and amniotic fluid were observed in all cases. The median GA at delivery was 35.2 (range: 30.6-38.0) weeks. There were no fetal deaths but one neonatal death (33%) secondary to renal failure and preterm delivery.
Conclusion:
In fetuses with LUTO by congenital obstructive megalourethra, FUM is feasible and is associated with good perinatal outcomes.
