Clinical neurological findings in 47 children with lumbosacral myelodysplasia did not correlate well with the existing dysfunction of the lower urinary tract as diagnosed by urodynamic studies. The level of intact skin sensation, and the presence or absence of bulbocavernosus and anal reflexes could not significantly predict the function of the detrusor muscle, proximal urethra and striated urethral sphincter. Therefore, one should not rely on a clinical neurological examination to outline the urological management in such patients.

SummaryWe report on our results with the intracavernous injection and self-injection of papaverine-phentolamine in a group of spinal cord injury patients with erectile impotence. This technique offers the possibility of achieving a full erection which continues for a few hours and disappears afterwards. In our limited experience no major complications have occurred. If our findings are confirmed, in future, the self-injection technique may become a valuable alternative to implanting a prosthesis in impotent paraplegics and tetraplegics.

SUIDIDaryIn a series of 115 spinal cord injury patients four different methods of bladder drainage were used mainly during spinal shock. That is a) suprapubic fine bore cystostomy, b), indwelling Foley catheter, c) intermittent catheterisation; and d) both last methods consecutively.The methods of bladder drainage used did not influence the number of patients becoming catheterfree but determined significantly the length of period before patients became catheterfree. Patients on intermittent catheterisation had the shortest time from injury to established micturition.Patients on intermittent catheterisation and on cystostomy had few complications but in those patients treated with an indwelling Foley catheter the complication rate was high.

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