THE combination of an easily distending lower motor neuron bladder and an atonic pelvic floor can result in a total impossibility, in certain cases, of voiding without surgical interference. In most cases, a single, or repeated T. U.R., of the bladder neck, is sufficient. However, if this, or these, should fail, the cause of retention must be found out, and in some cases, such procedures as an Y-V prostato-urethroplasty, or even electrostimulation, have been advocated to avoid a permanent indwelling catheter. In true L.M.N. lesions the missing contraction of the detrusor is replaced by abdominal strain, associated, or not, by 'Crede pressure'. This is sufficient as long as the internal sphincter is permeable. When this is not, the combination of backand down-tilting of the bladder base, and FIG. I Case report, Male, aged 45. Complete permanent flaccid paraplegia, below TI I on the right, LIon the left, due to communitive fracture of LI .

Abstract. A grouped Franco-Swiss study on 300 cases of spinal cord injury gives an overall view of the neurological evolution of the spinal cord injuries or cauda equina lesions. The importance of initial and repeated examinations is stressed. Sensory sparing distant to the lesion is of great importance, especially that of pain. A great number of patients showing neurological progress was observed at the end of the first month and at the beginning of the following three months. The influence of steroids is tentatively discussed. No complications due to this therapy have been observed on the condition that their use is very limited in time. Statistically speaking, there has been no difference of evolution in the two groups, the majority having been treated orthopedically.

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Abstract. The situation of the usual bladder, prostate, membranous urethra channel, can vary, according to the morphology of the perineum which can be overstretched. A case of a young man with a TIO complete upper motor neurone lesion is presented. The normal anterior angulation at the prostate and membranous urethra junction was reduced anteriorly and pushed backwards, thus causing an added indirect factor of dysuria. The mechanism is discussed in comparison with other such late, but often overlooked con sequences of alterations of the pelvic floor during micturition.