Early vesico-ureteral reflux following conus medullaris injury: case report

The authors describe severe vesico-ureteral reflux and simultaneous renal insufficiency which occurred after a spinal cord injury to the conus medullaris. They point out the misleading character of these injuries when there are only minimal neurological signs in the trunk and limbs. The main clinical consequence may be an isolated neuropathic bladder which, if not detected, delays treatment. Additionally, they underline the role of mixed bladder and sphincter lesions in the development of renal insufficiency; also the role of increased intravesical pressure during filling and emptying with bilateral vesico-ureteral reflux.