SCI interrupts control of the bladder[54]. Immediately after SCI, the bladder and sphincter are frequently hypotonic. In the chronic phase the bladder dysfunction is classified as either an upper or lower motor neuron syndrome. Upper motor neuron syndrome (reflex bladder) involves loss of cortical inhibition of sacral reflex arcs due to disturbance of descending spinal tracts, leading to detrusor hyperactivity often in combination with detrusor sphincter dyssynergia[55]. Inhibition of the stretch reflex by the pontine storage centre is abolished. A minor amount of stretch will give a contraction of the bladder wall, the external urethral sphincter lacks voluntary control, resulting in recurrent, spontaneous voiding. Lower motor neuron syndrome is due to injury to the sacral (S2-S4) part of the autonomic nervous system resulting in a diminished motor stimulation of the bladder and reduced or absent contractility of the detrusor and subsequently an enlarged bladder