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Objective To evaluate bladder function by conventional urodynamic investigations in young infants with primary vesico-ureteric reflux (VUR) who had undergone an initial temporary cutaneous vesicostomy followed by later antireflux surgery and vesicostomy closure. Patients and methods From 1983 to 1990, nine boys (10–360 days old) with primary VUR were treated with an initial vesicostomy, followed by delayed closure of the vesicostomy and the simultaneous surgical correction of reflux. Severe VUR was detected bilaterally in seven and unilaterally in two infants at the time of the initial diagnosis. The mean ( sd, range) age at vesicostomy was 12.4 (8, 3–23) months and the duration of bladder defunctionalization 38.7 (25.5, 18–90) months. All patients were assessed urodynamically after closing the vesicostomy, using rapid-fill cystometry with normal saline solution at room temperature. The mean (range) age at the time of urodynamic testing was 7.3 (5–15) years; the mean ( sd, range) follow-up was 10.1 (4.1, 5–17) years. Results Six boys with bilateral VUR underwent successful ureteroneocystostomy; nephroureterectomy was required in one patient. In two patients the VUR resolved with time. After re-functionalization, the mean ( sd, range) maximum cystometric capacity, expressed as a percentage of the mean bladder capacity for age, was 1.4 (0.5, 0.6–2.2)%. In three patients the bladder capacity was higher ( 40%) than expected for age, while one had diminished (