Physician Toolkit: Managing Lower Urinary Tract Obstruction and Complex Genitourinary Anomalies

Genitourinary anomalies are among the most common prenatally diagnosed birth defects. If you have a patient with a suspected genitourinary anomaly, we are here to help. Here at Children’s Hospital of Philadelphia you’ll find state-of-the-art prenatal diagnostic expertise and pediatric urologic specialists prepared to support you in the management of your patients. This combined expertise makes us uniquely qualified in the pre- and postnatal evaluation and management of all genitourinary anomalies, from lower urinary tract obstructions to bladder exstrophy.

To better partner with you, we have created a number of professional and patient-focused resources focused on the evaluation and treatment of urologic conditions.

Resources for professionals

LUTO evaluation algorithm

This lower urinary tract obstruction (LUTO) evaluation algorithm, developed by clinicians at the Center for Fetal Diagnosis & Treatment, provides an overview of the workup for megacystis.

Guidelines for vesicoamniotic shunting

Find detailed guidelines for vesicoamniotic shunting, including inclusion and exclusion criteria.

In Utero Insights Newsletter: Pathway to improved outcomes

The LUTO edition of In Utero Insights, the Center’s newsletter for healthcare professionals, features detailed information about evaluation and fetal surgery for LUTO, research updates on LUTO in the context of normal amniotic fluid volume, advances in urologic care as it related to caring for children with the exstrophy/epispadias complex, as well as news from the Fetal Heart Program regarding cardiovascular effects of LUTO. Read the articles online or download the print edition.

Continuing medical education

In this online CME course, Current Management of Prenatally Diagnosed Lower Urinary Tract Obstruction (LUTO), Mark Johnson, MD, and Michael C. Carr, MD, discuss current management of prenatally diagnosed lower urinary tract obstructions from the prenatal through postnatal period.

Take the course »

Resources you can share with patients

Condition information

Children’s Hospital of Philadelphia has detailed diagnosis-specific information about a wide variety of genitourinary conditions written specifically for families. We hope you will find these pages helpful as educational resources to share with your patients. Here are some examples of conditions frequently diagnosed before birth:

When a fetal ultrasound suggests ambiguous genitalia or gender discrepancy, a referral to the Center for Fetal Diagnosis and Treatment and the Urology-based Disorders of Sex Development Program can help to identify additional diagnostic options and counseling about possible outcomes of obstructive uropathy.

LUTO educational video

In this educational video developed for both medical professionals and families, CHOP experts present a complete overview of LUTO, from diagnosis and possible prenatal treatment, to delivery, treatment after birth, and follow-up care.

Share the video directly with your patients to watch online. You can also request a copy of the DVD by calling 1-800 IN UTERO (1-800-468-8376) or reaching out through our online contact form.

Patient stories

Many of our patient families have shared their experiences about what it was like to be diagnosed and treated for genitourinary anomalies, with the goal of helping other families who are facing a similar diagnosis. If your patient is looking for more information about what to expect, here are some stories told from the perspective of other families who have gone through similar experiences.

  • Mason was prenatally diagnosed with lower urinary tract obstruction (LUTO) and successfully treated with fetal surgery at CHOP. Mason’s story »
  • Owen was diagnosed with LUTO before he was born, and underwent successful fetal surgery at CHOP. After delivery, doctors also discovered he had a condition called prune belly syndrome. Owen’s story »
  • Born with his bladder outside of his body (bladder exstrophy), Bracken faced significant challenges. Read about how a multidisciplinary team worked together to manage his care. Bracken’s story »
  • In spring 2015, PBS aired “Twice Born: Stories from the Special Delivery Unit,” a three-part documentary series following families who received prenatal care at Children’s Hospital of Philadelphia. Watch the trailer »

Pregnant Mom and Child

Choosing a Fetal Treatment Center

Know what questions to ask when considering fetal surgery so you can make an informed decision that is right for you and your baby.

Pregnant Mom and Child

What to Expect

From the moment of referral through delivery and postnatal care, your family can expect a supportive experience when you come to us with a diagnosis of a birth defect.