The evolution of patterns of neurogenic vesical dysfunction with emphasis on urethral resistance has been studied using a two-catheter urethral profile technique in 24 patients following acute spinal cord injury. Inappropriate urethral resistance to voiding appeared to result both from smooth and skeletal muscular activity and to some extent was dependent on the level of the spinal cord lesion. Autonomic dysreflexia was common, and responded to treatment with an α-sympatholytic agent