This study included 20 patients who were diagnosed postnatally. 10 cases were found to have creatinine 1evels at or below 0.8 mg/dl at presentation. The other 10 cases were found to have creatinine levels higher than 0.8 mg/dl. The first group is classified as group1 and the 2nd group is classified as group II. The cases in each group were evaluated as regards improvement in hydronephrosis grade and reflux grade and also the lower urinary tract were evaluated radiologically both pre and post operative. All the patients were evaluated as regards improvement in their creatinine levels after management. All cases of group I were treated by endoscopic valve ablation. Cases in group II were treated as follows: Four vases were relatively old were treated by endoscopic valve ablation. The other six cases under went lower urinary diversion they were young age.