Thank you very much for your valuable opinion. As you indicated, changes in the patient's wish, environment, and urinary bladder function several years after injury require urinary tract management in patients with spinal cord injury, which we have often experienced. In this study, we examined vesicoureteral reflux (VUR) in patients with a short period after spinal cord injury. Therefore, further changes in our patients should be investigated. Your patients were controlled by penile sheath, and developed upper urinary tract disorder 7 years after injury. Infection and inflammation may have influenced the environment in the urinary bladder during the long period, causing morphological and functional disorders of the urinary bladder. Thus, long-term follow-up is needed for urinary tract management in patients with spinal cord injury.