Effect of Botox on the hypertrophied bladder wall in fetal lambs

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Posterior Urethral Valves (PUV) is a congenital anomaly almost entirely confined to boys. PUV often develop a specific bladder dysfunction that has become known as [PUV Bladder]. A recent development has been the use of Botulin Toxin (Botox) to treat bladder dysfunction, although this has not yet been tried in [Valve Bladder] patients. This study addresses the questions [will Botox modify the development of the hypertrophied fetal bladder?] and [what is the optimal dose of Botox in International Units/kg in the fetus?] We have shown that the placement of a non-valved shunt produces a hypertrophied bladder. This study is a pilot study to determine the feasibility of using Botox injected into the bladder wall to investigate whether the injection of Botox will improve the bladder development after the placement of a non-valved shunt and attempt to determine a possibly-effective dose.