The challenge in the management of children with exstrophy bladder or its variants is creating a functional reservoir for urine as well as creating some form of continence mechanism. Many of the children who undergo bladder neck procedure or sling result in raised leak point pressure damaging the nephrons in the long run. Urodynamic evaluation in these children once the child has achieved continence helps us guide further management and prevents renal deterioration. Video urodynamics in these children helps us to assess the vesicoureteral reflux, if any, in them and know at what level of bladder filling do they appear. The cystometric capacity, presence of VUR, and end filling pressure are known, which guide regarding the optimal surgery for further management.