RECUMBENCY HAS BEEN RECOGNIZED as an important factor in the genesis of urinary tract calculi.5 11,21 The literature concerning the factors involved in calculus formation is very extensive.3 17, 20, 22, 23 Considering that the major factors include recumbency, stasis, infection, and dietary dyscrasias, it is not at all surprising that patients suffering from injury to the spinal cord should have a high incidence of calculi in the urinary tract. The following report is based on observations made on over 700 young male adults (ages i8-50) who had suffered injury to the spinal cord during and shortly after World War II.In the first world-wide conflict, concentration of patients with spinal cord injury at special hospitals led Head and Riddoch'5 to list the course of paraplegia in four stages. These were: (I) The stage of flaccidity which began with the onset of the injury and continued for about six weeks; (2) The stage of spasticity when reflex activity developed and gradually increased in severity;(3) The stage of paraplegia in flexion when the spastic contractions had continued to the point where contractures had developed; and (4) The stage of loss of reflex activity which developed as debility and sepsis advanced, with death aS the final culmination. Undoubtedly, the history of the patients from the recent war would have been the same were it not for the advent of antibacterial agents and the recognition of the need for highly supervised bladder care such as that described by Munro.26 As a consequence of these advances, the outlook for the patient with spinal cord injury was improved. Despite this, two grave problems remained-the high incidence of urinary tract calculi with the concomitant presence of severe urinary tract infection, and the debilitating effect of huge decubitus ulcers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.