Over the last several decades voiding dysfunction in children has primarily been associated with incontinence and thought to be secondary to bladder instability from delayed brain maturation. Full urodynamic evaluation became the standard recommendation and treatment centred on early institution of anticholinergics. Recently, this strategy has been questioned as medical programs including pelvic floor muscle treatments have shown tremendous success in curing incontinence, decreasing surgical rates for vesicoureteral reflux, and decreasing recurrent urinary tract infections.