ABSTRACT
Better knowledge of the evolution and prognostic factors of neurological bladder has enabled the development of pertinent follow-up strategies, screening for risky situations, and taking account of aging urinary systems as well as aging spinal cord injury (SCI) patients themselves. In 1927, Harvey Cushing observed that 80% of SCI patients died within weeks after the trauma because of infections, urinary catheters, and bedsores. Bladder hyperpressure, either related to detrusor overactivity or related to poor bladder compliance in case of detrusor areflexia, will have a dual effect: hydrodynamic perturbations and morphological changes. All bladder drainage methods may preserve the upper urinary tract, but continuous drainage is a risk factor for upper urinary tract damage and renal failure. Flaccid and compliant bladders, due for instance to a cauda equina syndrome after a disk herniation, do not develop any changes of the bladder wall and upper urinary tract.
