The infravesical obstruction created by posterior urethral valves produces a series of structural, biochemical, and functional changes in these boys' bladders that begins during fetal life. Any change can be irreversible and result in the alterations in bladder function that can be found in some of these patients. Bladder instability, poor compliance, and myogenic failure are the three most common urodynamic patterns and are also responsible for some of these patients' poor long-term prognosis. Treatment of bladder dysfunction in these patients is basically directed toward improving their kidney function prognosis and also to avoid the urinary incontinence presented secondarily by some valve bladders.