The Section on Urology of the American Academy of Pediatrics met for 2½ days in conjunction with the 60th annual meeting of the American Academy of Pediatrics in New Orleans, LA, October 26 through 28, 1991. This conference remains the most important meeting in the United States for pediatric urology. The number and quality of papers presented continue to grow and there is a rich, international participation. The meeting was presided over by Chairperson Edward S. Tank, Jr, MD, of the University of Oregon Health Sciences Center, Portland, OR. The papers presented at this meeting that are of interest to the practicing pediatrician are summarized here according to topic.
Investigation of structural, biochemical, and functional changes in both the developing bladder and in the upper urinary tract were studied in the fetal lamb model of bladder outlet obstruction by Peters et al from Boston Children's Hospital and by Cendron et al from Johns Hopkins Hospital. Their findings included an increase in bladder weight due to hypertrophy and hyperplasia, increase in the cholinergic receptor density of the smooth muscle cells of the bladder, and alterations in the myosin heavy-chain isomer ratio. Following birth these alterations in growth and differentiation resulted in functional bladder abnormalities as measured by urodynamic studies. These abnormalities included an increase in bladder capacity, an increase in maximal intravesical pressure with filling, and an increase in postvoid residual urine volumes. Further study in this model should allow better understanding of the spectrum of bladder dysfunction resulting from in utero outflow obstruction of the bladder.