Fetal Bladder Outlet Obstruction Due to Ureterocele: In Utero "Colander" Therapy

Bladder outlet obstruction secondary to ureterocele is well documented. Fetal bladder obstruction due to ureterocele is usually monitored expectantly in utero and then treated in the neonatal period with endoscopic incision of the ureterocele. Fetal bladder outlet obstruction due to ureterocele has also been treated with in utero vesicocentesis. In utero surgery has been reported at 19 weeks with fetal cystoscopy (3.5-mm trocar) and laser incision of the ureterocele. In utero incision of a ureterocele has been performed at 28 weeks with a laser inserted under sonographic guidance through a 19-gauge needle. We present a case of fetal bladder outlet obstruction with a ureterocele relieved by in utero vesicocentesis and multiple "colander" punctures of the ureterocele by a single fetal insertion of a 20-gauge needle.