Normal bladder function is dependent upon neural components for storage and coordinated, controlled evacuation. Maturation of these nervous system functions is acquired in childhood to allow a transition from the reflex voiding of infancy to the inhibitable, controlled voiding required for adult living. Alterations in this transition may manifest themselves in benign forms such as nocturnal enuresis or more severe forms that threaten urinary anatomy and function. Understanding these characteristics may involve the application of urodynamic concepts and techniques. Therapy may be chosen to counter these disturbances. This may subsequently require revision of earlier traditional approaches to recurrent cystitis and reflux.