The primary objective in taking care of the spinal cord injury patients is preservation of renal function. We evaluated 28 cases with spinal cord injury, who underwent intravenous pyelography, voiding cystourethrography and urodynamic assessment
to
determine the effects of low bladder compliance, hyperrefexia and detrusor-sphincter dyssynergia on the upper tract during the past 5 years period. And also, and objective hostility score was introduced that would predict the fate of the upper
tracts
and help to determine the need of treatment. Urodynamic evaluation revealed that 17 of 28 cases (67%) had detrusor hyperreflexia and 11 cases (33%) had detrusor areflexia. Of the 28 cases, 12 cases (44%) had low compliant bladder. Hydronephrosis
was
present in six of the 12 cases (41%) that had low compliance. These results were in sharp contrast to the normal compliant bladder in which two of 16 cases (12%) had hydronephrosis. No case with a hostility score of less than 5 went onto develop
upper
tract changes. In conclusion, the patients with the hostility score of 6 or more were significantly at risk of developing upper tract damage. So, these patients should have adequate and frequent follow-up evaluation.
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