Prenatal and Postnatal Urologic Emergencies

The widespread availability of accurate imaging and genetic screening, and the active participation of pediatric urologists in a multidisciplinary approach to urologic problems have resulted in their detection during fetal development. Consequently, there are few true urologic emergencies since foresight offers the opportunity for counseling parents and planning treatment. As technology and genetic understanding continue to advance, the frequency with which diseases are identified in the prenatal period will continue to increase. These advances have and will continue to present difficult ethical and societal issues to the pediatric urologist, when the abnormalities discovered prenatally are severe enough to warrant consideration of prenatal intervention, possibly even termination of pregnancy. In this chapter, an overview of a variety of urological conditions presenting prenatally and during the first year of life only is offered. An emphasis is placed on information particularly useful to guide the consultative process. We begin by focusing on conditions that might be managed prenatally, and conclude with those for which management must be delayed—or are not recognized— until after birth.