Prenatal diagnosis: what do we know of long-term outcomes?
Although prenatal diagnosis has been a prominent feature of Paediatric Urology for more than two decades the published literature has been largely characterized by studies reporting short to medium-term follow up. This deficiency is now being addressed by the growing availability of published and unpublished long-term outcome data for a range of prenatally detected anomalies. This review analyses the evidence on long-term outcomes which is provided by studies with mean or median follow- up exceeding 5 years, with particular emphasis on the small number of studies reporting follow -up at 10 years and beyond. The natural history and outcome of conservatively managed uropathies is considered in conjunction with an appraisal of evidence- based indications for surgical intervention. This review evaluates the relative benefits and drawbacks of prenatal diagnosis for children and their parents and also considers the impact of prenatal diagnosis on the delivery of Paediatric Urological services and specialist training.