EP16.26: Congenital megalourethra: not your usual case of LUTO – case report and review of the literature
Bibliographic record
Abstract
31yo G3P1L1A1 had a 19-week morphology ultrasound that showed bilateral hydronephrosis and distended bladder with keyhole sign. A cystic structure arising from the perineum was noted (figure 1). Borderline low levels of amniotic fluid were detected. Lower urinary tract obstruction (LUTO) was suspected and patient was referred to our Maternal Fetal Medicine Unit for management. 21-week scan showed the same findings. Congenital megalourethra (CMU) in a male fetus was the primary hypothesis. Amniocentesis for genetic analysis and bladder tap for renal function investigation were performed simultaneously. Biochemical analysis and renal function results showed poor prognosis (beta-2-microglobulin = 11.2mg/L). Patient chose to terminate the pregnancy. Autopsy results confirmed a case of CMU secondary to hypoplasia of corpora cavernosa and spongiosa. No posterior or anterior urethral valves were noted. The cystic perineum structure seen on ultrasound was found to be an enlarged, flaccid penis. Bilateral hydronephrosis, hydroureters and distended bladder were also confirmed. CMU is rare fetal disorder. In a review of the literature, we found 46 case reports of CMU reported. Absence of the corpus spongiosum and/or corpus cavernosum is the main feature leading to the dilatation of urethra. Postnatal outcomes range from healthy infants to severe neonatal morbidity or fetal/neonatal death. Bilateral hydroureters, bilateral hydronephrosis, and severe oligohydramnios/anhydramnios appear to be associated with a poor prognosis (mortality and renal impairment). Affected individuals may have long-term consequences of impaired continence and fertility. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".