We followed 62 patients with complete suprasacral spinal cord injuries and detrusor-sphincter dyssynergia for at least 2 years. The patients were evaluated urodynamically at regular intervals and 50 per cent were subjected to external sphincterotomy, after which they were compared for the presence of bacteriuria and upper urinary tract changes. Patients on prolonged intermittent catheterization did as well as those who achieved balanced bladder function as a result of sphincterotomy.