Between 1988-1993 we performed lower urinary tract reconstruction in 30 patients with neurogenic bladder. The indications for surgery included urinary incontinence and/or upper urinary tract deterioration. 18 patients with a follow-up of longer than 18 months are reported. Continence was achieved in 15 of 16 patients and stabilization or improvement of the upper tracts in 17 of 18 patients. There was no mortality, and morbidity was the same as in similar series. Despite its complexity, lower urinary tract reconstruction in patients with neurogenic bladder brings major improvement in quality of life and in preservation of renal function. We recommend such operations in properly selected patients.