231 patients with neurogenic bladder dysfunction were evaluated for bladder deformities. Bladder deformity implies bladder trabeculation and deformity of bladder shape such as pine tree shape. Bladder deformity was judged radiographically at maximum cystometric capacity and classified into grade 0 (none), grade I (mild), grade II (moderate) and grade III (severe). Upper urinary tract deterioration (hydronephrosis and/or reflux) was found in 2% of grade 0, 8% of grade I, 52% of grade II and 62% of grade III. I suggested that bladder deformity was one of the risk factors for upper tract deterioration. High grade deformity (grade II and III) was found more frequently in traumatic spinal cord injury and spinal dysraphism than brain disease. Most patients with low compliance bladder had high grade bladder deformity. The management program including clean intermittent catheterization was effective in preventing bladder deformities.
