Objectives: The objectives of the study were to determine whether intrauterine vesico-amniotic shunting for fetal bladder outflow obstruction, versus a conservative non-interventional approach improves prenatal and postnatal mortality, morbidity, and renal functions of isolated lower urinary tract obstruction cases. We aimed to find a prognostic index for cases of fetal lower urinary tract obstruction and to determine the safety and efficacy of the shunting procedure. Patients and Methods: The study included 20 cases of lower urinary tract obstruction (LUTO). Initial ultrasonography was done to all our cases upon detection of tlhe lower urinary tract obstruction and a follow up ultrasounds were performed on 9 cases. The most important indicator to predict renal function was fetal bladder size. Bladder wall thickness, amniotic fluid index and the size of the kidney were of lesser value in the early detection of LUTO. Fetal urine analytes including Sodium, Potassium, Chloride, Calcium, Creatinine and B2 microglobulin were analyzed in 16 cases. In our study of 20 LUTO patients, 6 fell into the intervention group and 14 into the conservative group. Results: The perinatal and neonatal outcomes of the interventional group were 33.3% terminations of pregnancy, 33.3% miscarriage, 16.6% neonatal death and 16.6% alive at 28 days. The conservative group results included 36% terminations of pregnancy, 7% miscarriage, 14% neonatal deaths, 7% alive at 28 days and 36% dropouts. Conclusion: Fetal urine biochemical analysis results were not in accordance with the ultrasonographic results nor were they useful in predicting severity of disease and neonatal outcome. Fetal bladder sagittal length was the most important sign in early diagnosis of LUTO. Vesico-amniotic shunting did not alleviate the LUTO condition, nor did it affect neonatal mortality or morbidity.