Spina bifida is one of the most common birth defects with a prevalence of 1-1.5 per 1000 births in the UK and Ireland. Neurogenic bladder dysfunction in children with spina bifida can lead to secondary upper urinary tract deterioration and often causes chronic urinary incontinence. With growing number of spina bifida children reaching adolescence and adulthood, sexuality is an increasingly important issue. Bowel dysfunction is a major concern in spina bifida patients. Approximately 10-30% of children with repaired spina bifida will develop neurological deterioration related to tethered cord syndrome. The effect of untethering on lower urinary tract function is uncertain, but it is strongly advocated that there is surgical release of a symptomatic tethered cord irrespective of age. Fecodynamic studies allow early detection of neurogenic disturbances of the anorectum and may be beneficial for determination of the proper time for untethering surgery and also for monitoring in the postoperative follow-up.