SYNOPSISThe policy of conservative bladder training by manual expression has almost universally failed to keep the incontinent child dry, and the incidence of urinary infection in such children over 2 years of age is so high, that conservative methods appear to have favoured the development of pyelonephritis, especially in the presence of unrelieved urethral obstruction.A review of 130 incontinent patients suggests that early surgical diversion of urine, before renal damage becomes apparent, is preferable.