Intrinsic or bladder neck dysfunction can also be assessed. Detrusor overactivity occurring during bladder filling is defined as an involuntary detrusor contraction > 15 cm of water from baseline.13 Bladder underactivity is also abnormal and recognized in patients who are filled to > 150% of their chemical structure expected bladder capacity and have a poor or absent detrusor contraction. During filling, normal detrusor compliance is 10 cm of water at capacity, or 5% of the child’s normal capacity per

cm of water, or about 20 cm of Inhibitors,research,lifescience,medical water at expected bladder capacity.12,13 Infants tend to have higher voiding pressures than children, and boys tend to have higher voiding pressures (by 5 to 15 cm of water) than girls.2,19 Urethral obstruction is suggested when Inhibitors,research,lifescience,medical there are high voiding pressures accompanied by poor flow rates. EMG pads may show a staccato voiding pattern. A low flow rate may be indicative of an anatomical obstruction and bladder emptying should be assessed. This review of pediatric urodynamics is comprehensive and provides an excellent source of classic references.
The 29th World Congress of Endourology and SWL was held in Kyoto, Japan, from November 30 to December 3, 2011. Innovation was the Inhibitors,research,lifescience,medical theme of the meeting across a wide array of topics in endourology and minimally invasive surgery. This review highlights just some of the exciting presentations. Stone Disease As

the rates of shock wave lithotripsy continue to decline, a major focus of the meeting centered on ways to improve the performance of ureteroscopy and Inhibitors,research,lifescience,medical percutaneous nephrolithotomy (PCNL). During ureteroscopic laser lithotripsy, one problem is ensuring good clearance of residual stone fragments. A novel technique for this was presented using magnetic-coated amino acids that interact with the stone, allowing for magnetic-assisted fragment retrieval.1 For PCNL, the importance of flexible endoscopy during Inhibitors,research,lifescience,medical the initial procedure was emphasized to avoid the need for repeat procedures. With regard to technical improvements, one of the significant

hurdles to PCNL for many urologists may be obtaining their own percutaneous access. To this end, several novel solutions were presented ranging from ureteroscopic placement of magnets into the collecting Etomidate system to guide the incoming percutaneous needle, or alternatively, the ureteroscopic placement of a puncture wire in a retrograde fashion. 2,3 Although these options would conceptually allow for more precise access into the targeted calyx, they remain technically challenging in some cases and additional refinement of these techniques is necessary. The Clinical Research Office of the Endourological Society (CROES) prospectively collected data on 5803 patients who underwent PCNL as part of the PCNL Global Study. Five papers were presented in addition to a plenary session summarizing the results.