Most traumatic, congenital, neoplastic, or degenerative neurologic pathologies have direct consequences on vesicourethral function. Diagnosis of the complex urologic conditions will be based on a good history and evaluation of quality of life impact. Endoscopy will provide anatomic information, such as mucosal appearance, tumors, urethral stricture, degree of prostatic enlargement, and bladder stones. Traumatic injury to the central nervous system is often followed by the so-called spinal shock phase. The bladder is hypotonic during this phase, which may last from 2 weeks to 8 weeks but sometimes up to 1 year. Autonomic dysreflexia is an exaggerated sympathetic response to afferent stimulation when spinal cord injury is at the level of T6 or above. Urodynamics is the cornerstone in the diagnosis and management of neurogenic bladder dysfunction. Cystoscopy can detect bladder outlet obstruction due to urethral stricture or prostatic hypertrophy, and bladder abnormalities such as bladder tumor, trabeculation, and bladder stones.