Advertisement

Fetal Lower Urinary Tract Physiology: In Vivo Studies

  • Robert A. Mevorach
  • Barry A. Kogan
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 385)

Abstract

Fetal urine is an important contributor to amniotic fluid, and hence there is no question that the fetus voids in utero. However, the maturation of the fetal lower urinary tract function has not been studied extensively. Nonetheless, defining the developmental changes is critical to understanding the pathophysiology of abnormal voiding, both pre- and post-natally. For example, the long-term bladder problems in patients with posterior urethral valves, which can cause renal insufficiency, are directly related to developmental changes owing to the obstruction. Furthermore, abnormalities of lower urinary tract function are seen prenatally and result in problems with urine storage and elimination even before birth. As a consequence, some instances of prenatal hydronephrosis may be caused by in utero vesico-sphincteric dysfunction (Kopp and Greenfield 1993). Furthermore, the advent of many new technologies in the evaluation and treatment of fetal abnormalities now allows for intervention, in the form of decompression of the urinary tract, in cases of in utero hydronephrosis. Because these interventions are technically feasible, it behooves us to understand better the physiology of fetal lower urinary tract function in to direct treatment more effectively. As we improve our understanding of normal bladder and sphincteric function in the fetus, we will be able to distinguish better between innocent urinary tract changes worthy of observation and significant lower urinary tract disorders for which therapeutic intervention would be advantageous.

Keywords

Lower Urinary Tract Bladder Capacity Bladder Function Posterior Urethral Valve Bladder Contraction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cullen, M. T., Athanassiadis, A. P., Grannum, P., Green, J. J., and Hobins, J. C., 1989, In utero intravesicular pressure and the prune belly syndrome, Fetal Ther 4: 73–7.PubMedCrossRefGoogle Scholar
  2. Hata, T., and R. L. Deter, 1992, A review of fetal organ measurements obtained with ultrasound: normal growth, J Clin Ultrasound 20:155–74.PubMedCrossRefGoogle Scholar
  3. Kogan, B. A., and Iwamoto H. S., 1989, Lower urinary tract function in the sheep fetus: studies of autonomic control and pharmacologic responses of the fetal bladder, J Urol 141: 1019–24.PubMedGoogle Scholar
  4. Kopp, G., and Greenfield S. P., 1993, Effects of neurogenic bladder dysfunction in utero seen in neonates with myelodysplasia, Br J Urol 71:739–42.PubMedCrossRefGoogle Scholar
  5. Mevorach, R., Bogaert, G., Kogan, B., 1994, Role of nitric oxide in fetal urinary tract function, J Urol 152: 510–4PubMedGoogle Scholar
  6. Nicolaides, K. H., Rosen, D., Rabinowitz, R., and Campbell, S., 1988, Urine production and bladder function in fetuses with open spina bifida. Fetal Ther 3:135–40.PubMedCrossRefGoogle Scholar
  7. Rabinowitz, R., Peters, M. T., Vyas, S., Campbell, S., and Nicolaides, K. H., 1989, Measurement of fetal urine production in normal pregnancy by real-time ultrasonography, Am J Obstet Gynecol 161: 1264–6.PubMedCrossRefGoogle Scholar
  8. Wlodek, M. E., G. D. Thorburn, and Harding, R., 1989, Bladder contractions and micturition in fetal sheep: their relation to behavioral states, Am J Physiol. 257: R1526–32.PubMedGoogle Scholar
  9. Zimmer, E. Z., Chao, C. R., Guy, G. P., Marks, F., and Fifer, W. P., 1993, Vibroacoustic stimulation evokes human fetal micturition, Obstet Gynecol 81:178–80.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Robert A. Mevorach
    • 1
  • Barry A. Kogan
    • 1
  1. 1.Department of UrologyUniversity of California School of MedicineSan FranciscoUSA

Personalised recommendations