Dr. Mark P. Johnson, research chair in fetal therapy, discusses an overview of prenatal diagnosis of fetal lower urinary tract obstruction. Dr. Johnson describes the most common causes of lower urinary tract obstructions, progressive oligohydramnios, physical deformations, pulmonary hypoplasia, renal fibrocystic dysplasia, prune belly phenotype, fetal sheep models, in utero vesicoamniotic shunt therapy, fetal obstructive uropathy, kidney evaluation, evaluation of cortical parenchymal cysts, distal penile meatal stenosis, anterior urethral valves, patent arches, megacystic microcolon, hypoperistalsis syndrome, fetal karyotype analysis, evaluation of existing renal injury, prenatal urinary prognosis, shunt insertion technique, and fetal karyotype analysis by urine test. Dr. Ryan describes management options for fetal lower urinary tract obstruction, fetal bladder shunt insertion, amnioinfusion, bladder drainage impact on perinatal survival, PLUTO trial, spontaneous bladder decompression, megacystis microcolon Intestinal hypoperistalsis syndrome, and cloacal dysgenesis.