Abstract

The goal of rehabilitation of the paraplegic patient is threefold: medical, physical and vocational-industrial. The urological part of the medical rehabilitation and physical rehabilitation must start as a synchronized effort immediately after the injury. In World War I only 20 per cent of the spinal cord casualties reached the United States, while 80 per cent died overseas. This ratio was dramatically reversed in World War II, with a survival rate of 80 to 88 per cent of the returning soldiers.<sup>1</sup>Table 1 illustrates the high mortality from genitourinary causes in World War I as contrasted with the low incidence of genitourinary deaths in World War II. This progress must be attributed to the improved understanding of the pathophysiology of the neurogenic bladder and its associated complications and to the advent of sulfonamide drugs and antibiotics. <h3>BLADDER PHYSIOLOGY</h3> The function of the bladder consists in storage and elimination. Elimination starts

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