g Neurogenic bladder predisposes to recurrent urinary tract infections (UTI) and renal failure, and susceptibility is commonly ascribed to urinary stasis from elevated residual urine volumes. Escherichia coli UTI was modeled in the spinal cord-injured (SCI) rat with the hypothesis that SCI animals would require fewer bacteria to establish infection, have an exaggerated inflammatory response, and have delayed clearance of infection compared to normal-voiding controls. T10 SCI rats and controls had median infectious doses (ID 50 ) of 10 2 and 10 5 CFU, respectively. Mean residual volumes in the SCI animals did not correlate with susceptibility to initiation of UTI or outcome. In the acute infection, control and SCI rats developed acute cystitis and pyelitis without acute differences in histopathological scores of inflammation. However, in vivo imaging of infected animals revealed persistently higher levels of bacteria in the SCI urine and bladders than were seen for controls over 2 weeks. Likewise, at 2 weeks, acute and chronic inflammatory infiltrates persisted in the bladders and kidneys of SCI rats, whereas inflammation largely resolved within the controls. Together these data demonstrate that SCI rats exhibit delayed clearance of infection and exaggerated inflammatory responses in bladders and kidneys; however, the severity of residual volumes does not predict increased susceptibility to UTI. These studies suggest that host-dependent mechanisms that are discrete from alterations in bladder physiology influence UTI susceptibility with the SCI-neurogenic bladder. This model will allow elucidation of SCI-neurogenic bladder-mediated changes in host response that yield UTI susceptibility and may lead to new preventative and therapeutic options. N eurogenic bladder refers to bladder dysfunction that is secondary to disruption of the central or peripheral nervous system pathways that regulate bladder storage and emptying. In children, the most common causes of neurogenic bladder are neural tube defects, such as spina bifida (myelomeningocele), while in adults, the most common cause is trauma-related spinal cord injury (SCI). Regardless of etiology, all patients with neurogenic bladder are at significantly increased risk for recurrent urinary tract infections (UTI) compared to the normally voiding population, with an annual incidence as high as 20 to 25% (1).A number of risk factors have been postulated for the increased susceptibility to UTI in patients with neurogenic bladder. They include urinary stasis due to elevated postvoid residual volumes, bladder overdistention, high-pressure voiding, vesicoureteral reflux, nephrolithiasis, and the use of chronic indwelling catheters. Many patients with neurogenic bladder perform scheduled clean intermittent catheterizations (CIC) to assist with bladder emptying. However, these individuals still have a 4-fold-increased risk of UTI compared to those who do not perform CIC (2, 3). Given the frequency of UTI, many neurogenic bladder patients are exposed to repeated courses of t...