Effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review
Objective To determine the effectiveness of fetal cystoscopy in the prenatal diagnosis of and intervention for congenital lower urinary tract obstruction. Methods This study was a literature search using MEDLINE, Embase, Cochrane Library, MEDION, Web of Science reference lists and contact with exper...
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| Veröffentlicht in: | Ultrasound in obstetrics & gynecology 2011-06, Vol.37 (6), p.629-637 |
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| creator | Morris, R. K. Ruano, R. Kilby, M. D. |
| description | Objective
To determine the effectiveness of fetal cystoscopy in the prenatal diagnosis of and intervention for congenital lower urinary tract obstruction.
Methods
This study was a literature search using MEDLINE, Embase, Cochrane Library, MEDION, Web of Science reference lists and contact with experts. All studies reporting on fetal cystoscopy in lower urinary tract obstruction with data for a 2 × 2 table were selected for review. No language restrictions were applied. There was independent selection of studies, data extraction and quality assessment by two reviewers. Peto odds ratios were calculated as a summary measure of effect.
Results
A total of 2071 citations were identified and 66 papers selected for detailed evaluation, from which four papers with a total of 63 patients were selected for inclusion. Two papers had results for the use of cystoscopy in diagnosis, showing that fetal cystoscopy altered the ultrasound diagnosis of the underlying pathology in 36.4 and 25.0% of fetuses, respectively. Compared to no treatment, fetal cystoscopic intervention demonstrated an odds ratio for improved perinatal survival of 20.51 (95% CI, 3.87–108.69). However, comparing vesicoamniotic shunt (VAS) with fetal cystoscopy there appeared to be no significant improvement in the perinatal survival odds ratio of 1.49 (95% CI, 0.13–16.97). These results had wide CIs and for cystoscopy vs. VAS, all results crossed the line of no effect.
Conclusion
There is little published evidence for the effectiveness of therapeutic fetal cystoscopy as an intervention for congenital lower urinary tract obstruction and the quality of this evidence is poor. It should thus be considered to be an ‘experimental intervention’ and subjected to further investigation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/uog.8981 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_868997079</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>868997079</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5111-65aab7c1c65f6e69af991470f2a2d849f9d766ebc0b5c0abea3c0c909918e3953</originalsourceid><addsrcrecordid>eNp9kdFqFTEQhoMo9lgFn0ACIvVma7KbTTbeSamtUOhNe73MZic1ZU9yTLI9nCfwtZu1RwsFezGEgW--YfIT8p6zY85Y_WUON8ed7vgLsuJC6oop1r4kK6Ylq5TU9QF5k9ItY0yKRr4mBzVvlFCiW5Hfp9aiye4OPaZEg6UWM0zU7FIOyYTNjkKiQEcHNz6k7AwFP9L8EyNscF565zPGMp9d8NSGSKewxUjn6DzEHc0RTKZhSDnOZmG-Fl0qelzDMh7xzuH2LXllYUr4bv8ekuvvp1cn59XF5dmPk28XlWk555VsAQZluJGtlSg1WK25UMzWUI-d0FaPSkocDBtaw2BAaAwzmhWqw0a3zSE5evBuYvg1Y8r92iWD0wQew5z6TnZaK6Z0IT8_S3LGlVacy0X68Ql6G-boyx09b7kSrWKiexSaGFKKaPtNdOvyRUXVLzH2JcZ-ibGgH_bCeVjj-A_8m1sBPu0BSAYmG8Eblx45UfNSC1c9cFs34e6_C_vry7M_i-8BQxq11A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1517457048</pqid></control><display><type>article</type><title>Effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Morris, R. K. ; Ruano, R. ; Kilby, M. D.</creator><creatorcontrib>Morris, R. K. ; Ruano, R. ; Kilby, M. D.</creatorcontrib><description>Objective
To determine the effectiveness of fetal cystoscopy in the prenatal diagnosis of and intervention for congenital lower urinary tract obstruction.
Methods
This study was a literature search using MEDLINE, Embase, Cochrane Library, MEDION, Web of Science reference lists and contact with experts. All studies reporting on fetal cystoscopy in lower urinary tract obstruction with data for a 2 × 2 table were selected for review. No language restrictions were applied. There was independent selection of studies, data extraction and quality assessment by two reviewers. Peto odds ratios were calculated as a summary measure of effect.
Results
A total of 2071 citations were identified and 66 papers selected for detailed evaluation, from which four papers with a total of 63 patients were selected for inclusion. Two papers had results for the use of cystoscopy in diagnosis, showing that fetal cystoscopy altered the ultrasound diagnosis of the underlying pathology in 36.4 and 25.0% of fetuses, respectively. Compared to no treatment, fetal cystoscopic intervention demonstrated an odds ratio for improved perinatal survival of 20.51 (95% CI, 3.87–108.69). However, comparing vesicoamniotic shunt (VAS) with fetal cystoscopy there appeared to be no significant improvement in the perinatal survival odds ratio of 1.49 (95% CI, 0.13–16.97). These results had wide CIs and for cystoscopy vs. VAS, all results crossed the line of no effect.
Conclusion
There is little published evidence for the effectiveness of therapeutic fetal cystoscopy as an intervention for congenital lower urinary tract obstruction and the quality of this evidence is poor. It should thus be considered to be an ‘experimental intervention’ and subjected to further investigation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</description><identifier>ISSN: 0960-7692</identifier><identifier>ISSN: 1469-0705</identifier><identifier>EISSN: 1469-0705</identifier><identifier>DOI: 10.1002/uog.8981</identifier><identifier>PMID: 21374748</identifier><identifier>CODEN: UOGYFJ</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Biological and medical sciences ; Cystoscopes ; Cystoscopy - methods ; Data processing ; Endoscopy ; Female ; fetal cystoscopy ; Fetal Diseases - diagnosis ; Fetal Diseases - therapy ; Fetuses ; Gynecology ; Gynecology. Andrology. Obstetrics ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Language ; lower urinary tract obstruction ; Medical sciences ; Nephrology. Urinary tract diseases ; Obstetrics ; Pregnancy ; Prenatal diagnosis ; Prenatal Diagnosis - methods ; Quality control ; Shunts ; Survival ; systematic review ; Therapeutic applications ; Ultrasound ; Urethral Obstruction - congenital ; Urethral Obstruction - diagnosis ; Urethral Obstruction - embryology ; Urethral Obstruction - therapy ; Urinary Bladder - abnormalities ; Urinary Bladder - embryology ; Urinary system involvement in other diseases. Miscellaneous ; Urinary tract ; Urinary tract. Prostate gland ; vesicoamniotic shunt ; vesicocentesis</subject><ispartof>Ultrasound in obstetrics & gynecology, 2011-06, Vol.37 (6), p.629-637</ispartof><rights>Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5111-65aab7c1c65f6e69af991470f2a2d849f9d766ebc0b5c0abea3c0c909918e3953</citedby><cites>FETCH-LOGICAL-c5111-65aab7c1c65f6e69af991470f2a2d849f9d766ebc0b5c0abea3c0c909918e3953</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fuog.8981$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fuog.8981$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24212428$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21374748$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morris, R. K.</creatorcontrib><creatorcontrib>Ruano, R.</creatorcontrib><creatorcontrib>Kilby, M. D.</creatorcontrib><title>Effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review</title><title>Ultrasound in obstetrics & gynecology</title><addtitle>Ultrasound Obstet Gynecol</addtitle><description>Objective
To determine the effectiveness of fetal cystoscopy in the prenatal diagnosis of and intervention for congenital lower urinary tract obstruction.
Methods
This study was a literature search using MEDLINE, Embase, Cochrane Library, MEDION, Web of Science reference lists and contact with experts. All studies reporting on fetal cystoscopy in lower urinary tract obstruction with data for a 2 × 2 table were selected for review. No language restrictions were applied. There was independent selection of studies, data extraction and quality assessment by two reviewers. Peto odds ratios were calculated as a summary measure of effect.
Results
A total of 2071 citations were identified and 66 papers selected for detailed evaluation, from which four papers with a total of 63 patients were selected for inclusion. Two papers had results for the use of cystoscopy in diagnosis, showing that fetal cystoscopy altered the ultrasound diagnosis of the underlying pathology in 36.4 and 25.0% of fetuses, respectively. Compared to no treatment, fetal cystoscopic intervention demonstrated an odds ratio for improved perinatal survival of 20.51 (95% CI, 3.87–108.69). However, comparing vesicoamniotic shunt (VAS) with fetal cystoscopy there appeared to be no significant improvement in the perinatal survival odds ratio of 1.49 (95% CI, 0.13–16.97). These results had wide CIs and for cystoscopy vs. VAS, all results crossed the line of no effect.
Conclusion
There is little published evidence for the effectiveness of therapeutic fetal cystoscopy as an intervention for congenital lower urinary tract obstruction and the quality of this evidence is poor. It should thus be considered to be an ‘experimental intervention’ and subjected to further investigation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</description><subject>Biological and medical sciences</subject><subject>Cystoscopes</subject><subject>Cystoscopy - methods</subject><subject>Data processing</subject><subject>Endoscopy</subject><subject>Female</subject><subject>fetal cystoscopy</subject><subject>Fetal Diseases - diagnosis</subject><subject>Fetal Diseases - therapy</subject><subject>Fetuses</subject><subject>Gynecology</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Language</subject><subject>lower urinary tract obstruction</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Obstetrics</subject><subject>Pregnancy</subject><subject>Prenatal diagnosis</subject><subject>Prenatal Diagnosis - methods</subject><subject>Quality control</subject><subject>Shunts</subject><subject>Survival</subject><subject>systematic review</subject><subject>Therapeutic applications</subject><subject>Ultrasound</subject><subject>Urethral Obstruction - congenital</subject><subject>Urethral Obstruction - diagnosis</subject><subject>Urethral Obstruction - embryology</subject><subject>Urethral Obstruction - therapy</subject><subject>Urinary Bladder - abnormalities</subject><subject>Urinary Bladder - embryology</subject><subject>Urinary system involvement in other diseases. Miscellaneous</subject><subject>Urinary tract</subject><subject>Urinary tract. Prostate gland</subject><subject>vesicoamniotic shunt</subject><subject>vesicocentesis</subject><issn>0960-7692</issn><issn>1469-0705</issn><issn>1469-0705</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kdFqFTEQhoMo9lgFn0ACIvVma7KbTTbeSamtUOhNe73MZic1ZU9yTLI9nCfwtZu1RwsFezGEgW--YfIT8p6zY85Y_WUON8ed7vgLsuJC6oop1r4kK6Ylq5TU9QF5k9ItY0yKRr4mBzVvlFCiW5Hfp9aiye4OPaZEg6UWM0zU7FIOyYTNjkKiQEcHNz6k7AwFP9L8EyNscF565zPGMp9d8NSGSKewxUjn6DzEHc0RTKZhSDnOZmG-Fl0qelzDMh7xzuH2LXllYUr4bv8ekuvvp1cn59XF5dmPk28XlWk555VsAQZluJGtlSg1WK25UMzWUI-d0FaPSkocDBtaw2BAaAwzmhWqw0a3zSE5evBuYvg1Y8r92iWD0wQew5z6TnZaK6Z0IT8_S3LGlVacy0X68Ql6G-boyx09b7kSrWKiexSaGFKKaPtNdOvyRUXVLzH2JcZ-ibGgH_bCeVjj-A_8m1sBPu0BSAYmG8Eblx45UfNSC1c9cFs34e6_C_vry7M_i-8BQxq11A</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Morris, R. K.</creator><creator>Ruano, R.</creator><creator>Kilby, M. D.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>201106</creationdate><title>Effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review</title><author>Morris, R. K. ; Ruano, R. ; Kilby, M. D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5111-65aab7c1c65f6e69af991470f2a2d849f9d766ebc0b5c0abea3c0c909918e3953</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Biological and medical sciences</topic><topic>Cystoscopes</topic><topic>Cystoscopy - methods</topic><topic>Data processing</topic><topic>Endoscopy</topic><topic>Female</topic><topic>fetal cystoscopy</topic><topic>Fetal Diseases - diagnosis</topic><topic>Fetal Diseases - therapy</topic><topic>Fetuses</topic><topic>Gynecology</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Language</topic><topic>lower urinary tract obstruction</topic><topic>Medical sciences</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Obstetrics</topic><topic>Pregnancy</topic><topic>Prenatal diagnosis</topic><topic>Prenatal Diagnosis - methods</topic><topic>Quality control</topic><topic>Shunts</topic><topic>Survival</topic><topic>systematic review</topic><topic>Therapeutic applications</topic><topic>Ultrasound</topic><topic>Urethral Obstruction - congenital</topic><topic>Urethral Obstruction - diagnosis</topic><topic>Urethral Obstruction - embryology</topic><topic>Urethral Obstruction - therapy</topic><topic>Urinary Bladder - abnormalities</topic><topic>Urinary Bladder - embryology</topic><topic>Urinary system involvement in other diseases. Miscellaneous</topic><topic>Urinary tract</topic><topic>Urinary tract. Prostate gland</topic><topic>vesicoamniotic shunt</topic><topic>vesicocentesis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morris, R. K.</creatorcontrib><creatorcontrib>Ruano, R.</creatorcontrib><creatorcontrib>Kilby, M. D.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Ultrasound in obstetrics & gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morris, R. K.</au><au>Ruano, R.</au><au>Kilby, M. D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review</atitle><jtitle>Ultrasound in obstetrics & gynecology</jtitle><addtitle>Ultrasound Obstet Gynecol</addtitle><date>2011-06</date><risdate>2011</risdate><volume>37</volume><issue>6</issue><spage>629</spage><epage>637</epage><pages>629-637</pages><issn>0960-7692</issn><issn>1469-0705</issn><eissn>1469-0705</eissn><coden>UOGYFJ</coden><abstract>Objective
To determine the effectiveness of fetal cystoscopy in the prenatal diagnosis of and intervention for congenital lower urinary tract obstruction.
Methods
This study was a literature search using MEDLINE, Embase, Cochrane Library, MEDION, Web of Science reference lists and contact with experts. All studies reporting on fetal cystoscopy in lower urinary tract obstruction with data for a 2 × 2 table were selected for review. No language restrictions were applied. There was independent selection of studies, data extraction and quality assessment by two reviewers. Peto odds ratios were calculated as a summary measure of effect.
Results
A total of 2071 citations were identified and 66 papers selected for detailed evaluation, from which four papers with a total of 63 patients were selected for inclusion. Two papers had results for the use of cystoscopy in diagnosis, showing that fetal cystoscopy altered the ultrasound diagnosis of the underlying pathology in 36.4 and 25.0% of fetuses, respectively. Compared to no treatment, fetal cystoscopic intervention demonstrated an odds ratio for improved perinatal survival of 20.51 (95% CI, 3.87–108.69). However, comparing vesicoamniotic shunt (VAS) with fetal cystoscopy there appeared to be no significant improvement in the perinatal survival odds ratio of 1.49 (95% CI, 0.13–16.97). These results had wide CIs and for cystoscopy vs. VAS, all results crossed the line of no effect.
Conclusion
There is little published evidence for the effectiveness of therapeutic fetal cystoscopy as an intervention for congenital lower urinary tract obstruction and the quality of this evidence is poor. It should thus be considered to be an ‘experimental intervention’ and subjected to further investigation. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>21374748</pmid><doi>10.1002/uog.8981</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Biological and medical sciences Cystoscopes Cystoscopy - methods Data processing Endoscopy Female fetal cystoscopy Fetal Diseases - diagnosis Fetal Diseases - therapy Fetuses Gynecology Gynecology. Andrology. Obstetrics Humans Investigative techniques, diagnostic techniques (general aspects) Language lower urinary tract obstruction Medical sciences Nephrology. Urinary tract diseases Obstetrics Pregnancy Prenatal diagnosis Prenatal Diagnosis - methods Quality control Shunts Survival systematic review Therapeutic applications Ultrasound Urethral Obstruction - congenital Urethral Obstruction - diagnosis Urethral Obstruction - embryology Urethral Obstruction - therapy Urinary Bladder - abnormalities Urinary Bladder - embryology Urinary system involvement in other diseases. Miscellaneous Urinary tract Urinary tract. Prostate gland vesicoamniotic shunt vesicocentesis |
| title | Effectiveness of fetal cystoscopy as a diagnostic and therapeutic intervention for lower urinary tract obstruction: a systematic review |
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