[Bladder-sphincter disorders in patients with spinal cord injuries]

Improvement in the management of neuropathic bladders in spinal cord injury has considerably increased the life expectancy of these patients. The classical classification in central or peripheric neuropathic bladders, now leave place to a functional, clinical, and urodynamic classification. Three periods define the evolution of the neuropathic bladders: the initial period (drainage), the reeducation phase, and the stabilized period. Urodynamic investigations detect situations of risk (high intravesical pressures) and allow therapeutic adjustment. Intermittent catheterization has transformed neuro-urology and allowed deliberate choice of retention. Long term follow up is imperative (urodynamic study, echography, intravenous urography) to avoid secondary degradation.