Hunter Comes Through Bladder Outlet Obstruction Surgery Successfully. Hunter is a survivor of fetoscopic surgery that repaired his bladder outlet obstruction before he was born. He’s now a happy 18-month-old.

Destini Pair went in for a routine ultrasound when she was 22 weeks pregnant with her first child. She and her husband, Mason, of St. George, Georgia, were excited to find out if they were having a boy or a girl. Their excitement quickly turned to worry as the ultrasound showed a big black mass in their baby boy’s belly.

The Pairs were sent to a specialist the next day who diagnosed the condition as bladder outlet obstruction. The black mass was urine that was backed up inside their son, who they would later name Hunter. A blockage in his urethra was stopping the urine from leaving his bladder the way it normally should. Action was needed quickly, as further build-up of urine would threaten his life.

“I felt helpless,” Destini said. “We had never heard of bladder outlet obstruction before. I was terrified.”

The Pairs were referred to the Cincinnati Fetal Center, whose team of experts would evaluate all aspects of Hunter’s condition to see what medical interventions might help.

Learning Their Options

Once in Cincinnati, Destini underwent imaging studies and other tests to aid her care team in determining all possible treatment options for Hunter and his mother. The next day she sat in a meeting with all team members involved, from surgeons to social worker. Destini learned there were two options available that had the potential to save Hunter’s life.

The team carefully explained the situation, presented the interventions, discussed the impact on delivery, and went over potential medical issues Hunter could face after birth. Destini discovered Hunter’s urethra was completely blocked. Her amniotic fluid was low enough that if not corrected, Hunter’s lungs wouldn’t be able to develop. “During the round table discussion before surgery there was a pediatric doctor, nephrologist, urologist, and many nurses and caseworkers,” Destini explained. “I knew Hunter would be born with kidney damage. We just weren’t sure how damaged they would be. Dialysis at birth was a possibility if the kidneys weren’t doing their job at all. I felt very prepared for what we were about to go through.”

The Pairs ultimately chose for Destini to undergo fetoscopic surgery. In this surgery, small incisions were made in Destini’s uterus and surgeons placed a stent in Hunter’s urethra to allow the urine to drain from his bladder.

Several days later, Destini’s follow-up visit showed the surgery was successful. Hunter’s urine was not backing up any more. Destini was sent home to Georgia where she was to be on modified bed rest for the remainder of her pregnancy.

Meeting Hunter

A scheduled C-section at 37 weeks introduced the Pairs to their baby boy. They met him briefly before he was sent to the neonatal intensive care unit (NICU) where he stayed for two weeks. Mason and Destini were prepared for the NICU stay, thanks to the guidance provided by their Cincinnati Fetal Center team.

While the fetoscopic surgery was a success, Hunter, now 18 months old, isn’t entirely out of the woods. He has permanent kidney damage due to his bladder outlet obstruction. That will be a lifelong condition for him. But the Pairs were ready for that and more. “I was told by the Cincinnati Fetal Center team all the things we would have to face when Hunter was born,” Destini said.

Hunter’s sees many specialists for medical issues related to his kidney damage. He takes seven medications a day to regulate his kidneys and for an unrelated heart condition. He has had two additional surgeries since being born.

But what the Pairs focus on is the fact that Hunter is alive. And despite all he’s been through, he’s a happy little toddler. “He has a very strong personality. He knows what he wants. He’s super loving and is very smart,” his proud mom said. “There are not enough words to express how thankful I am. Without the Cincinnati Fetal Center, I wouldn’t have gotten to meet my baby.”