ABSTRACT
Advances in the urological care in spinal cord injury (SCI) mean that urological causes of death, the foremost cause of death in the 1940s and 1950s, had dropped to the fourth rank in the 1980s and 1990s and has probably diminished yet further since then. The external urethral sphincter releases urine only when it is socially desirable to do so. During urine storage bladder pressure is low and external sphincter pressure is high. High bladder pressures exhibit a number of variations. Bladder pressure rises progressively during filling, such bladders being unable to store urine at low pressures. The essential clinical problems experienced by the individual with a SCI are urinary incontinence, retention, recurrent urinary tract infections (UTIs), urinary tract stone formation and potentially renal impairment. The form of bladder emptying that is initially adopted is principally determined by the patient's hand function and to a lesser extent by their age and general mobility.
