From 1956 to 1991, 49 cases of the prune belly syndrome were seen at our institution. Voiding information and/or 1 or more urodynamic studies were available in 30 male and 4 female patients. Analysis of multiple urodynamic studies during long-term followup periods ranging from 6 months to 19 years, with particular regard to any reconstructive procedures performed, revealed that voiding in the prune belly syndrome is variable, with 44% of the patients achieving spontaneous voiding and 56% requiring clean intermittent catheterization. The ability to void or need for clean intermittent catheterization was by no means permanent, indicating the need for meticulous followup. The 3 distinct voiding patterns observed included an approximately normal pattern, prolonged voiding with a low peak and an intermittent pattern. These 3 voiding patterns did not correlate with residual volumes. Comparison of urodynamic voiding parameters between reconstructed voiding patients and nonreconstructed voiding patients did not show significant differences.