Health Technology Assessment (Winchester, England)
BACKGROUND: Congenital lower urinary tract obstruction (LUTO) is a disease associated with high perinatal mortality and childhood morbidity. Fetal vesicoamniotic shunting (VAS) bypasses the obstruction with the potential to improve outcome. OBJECTIVE: To determine the effectiveness, cost-effectiveness and patient acceptability of VAS for fetal LUTO. DESIGN: A multicentre, randomised controlled trial incorporating a prospective registry, decision-analytic health economic model and preplanned Bayesian analysis using elicited opinions.
Recently, a study was made of 8 boys with complications after corrective surgical procedures for dysfunction of the voiding mechanism. One of these patients already had been subjected to irreversible diversion before the basic disorder was recognized but the majority was treated with suggestion (often with hypnosis) as well as with drugs affecting the smooth muscle (1 adolescent was too hostile to accept treatment).