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were non-ambulatory and non-verbal; 40% lived in assisted living. The average initial age for urologic evaluation was 40 years old (range 15-71 years). Eleven patients (14%) died at an average age of 57 years old; the most common reason was aspiration pneumonia. Thirteen patients (17%) had kidney stones of whom 4 required percutaneous cystolithotomy. The most common reasons for urologic consultation were urge/frequency (49%), recurrent UTI (43%), retention or infrequent voiding (42%), and voiding difficulty (33%). At last followup, 56% were voiding, 19% relied on CIC, and 16% had an indwelling catheter.CONCLUSIONS: Our review reveals that despite having an early, fixed neurologic insult, many with CP present in mid-adulthood with new onset urinary complaints and nephrolithiasis. They are a heterogeneous and medically complex group of patients whose functional disability and social situations present unique challenges; a deliberate urologic evaluation and partnership with their caregivers both at home and at the skilled facilities is crucial to optimize their management.