Fetal Cystoscopy for Lower Urinary Tract Obstruction

Inclusion Criteria: * Fetus with LUTO, dilated bladder, "keyhole sign" and bilateral hydronephrosis * Oligohydramnios or Anhydramnios after 18 weeks * "Favorable urine analysis after 18 weeks (urinary sodium is \< 100mEq/L, chloride \< 90mEq/L, osmolarity \<200mOsm/L and β2-microglobulin \<6mg/L 7) * Absence of chromosomal abnormalities and associated anomalies (Normal karyotype by invasive testing (amniocentesis or CVS)) * Gestational age at the time of the procedure will be between 16 0/7 weeks and 25 6/7 weeks Exclusion Criteria: * Fetal anomaly unrelated to LUTO * Congenital cardiac anomaly * Increased risk for preterm labor including short cervical length (\<1.5 cm), history of incompetent cervix with or without cerclage, and previous preterm birth * Placental abnormalities (previa, abruption, accreta) known at time of enrollment - A body-mass index ≥ 35 * Contraindications to surgery including previous hysterotomy in active uterine segment * Technical limitations precluding fetoscopic surgery, such as uterine fibroids, fetal membrane separation, uterine anomalies incompatible with fetoscopy * Maternal-fetal Rh isoimmunization, Kell sensitization or neonatal alloimmune thrombocytopenia affecting the current pregnancy * Maternal HIV, Hepatitis-B, Hepatitis-C status positive because of the increased risk of transmission to the fetus during maternal-fetal surgery. If the patient's HIV or Hepatitis status is unknown, the patient must be tested and found to have negative r…