According to the latest WHO data published in April 2011 Kidney Disease Deaths in Egypt reached 18,860 per year or 5.19% of total deaths. The age adjusted Death Rate is 36.41 per 100,000 of population ranks Egypt #12 in the world. Costs for dialysis and renal transplantation are still unaffordable for most patients with ESRD. Kidney transplantation is generally acknowledged as the more clinically effective and more cost-effective option in managing patients with end-stage renal disease. The aim of the study is to compare the outcome of renal transplantation in obstructive uropathy and dysfunctional urinary bladder in pediatric patients to patients with normal lower urinary tract. It is the objective of this study to clarify any required ancillary procedures (e.g. augmentation, cystoscopy, etc.) and measures (e.g. prophylactic antibiotics) needed to maintain the graft survival in patients with obstructive uropathy and voiding dysfunction (OU-VD). The follow-up of the patients included as well back pressure changes in the graft as well as voiding diaries of those patients.