A 13-year-old boy came to RSUP Haji Adam Malik Medan on March 20, 2014 complaining of frequent urination and only 40–60 cc of urine came out every time he urinates. This complaint has been experienced by the patient since the patient was 8 years old. The patient complained of urinating at intervals of every 30 min every urination. Intermittent back pain on the right side was experienced by the patient one year ago. On ultrasound and BNO-IVP (Blass Nier Overzicht – Intravenous Pyelography) examination, non-visual conclusion, right kidney pyonephrosis and left kidney hydronephrosis were found. The patient then underwent a right kidney nephrostomy on March 24, 2014 due to pyonephrosis. From the CT scan of the abdomen on March 25, 2015, multiple stones of the right kidney were found, accompanied by bilateral hydronephrosis and hydroureter. Then a nephrectomy was performed on April 24, 2015 for pyonephrosis and non-visual right kidney. On April 7, 2015 the patient underwent cystography and voiding cystourethrogram (VCUG) with the conclusion of low-capacity bladder, grade 1 vesicoureteral reflux (VUR) on the right side, grade 4 VUR on the left side accompanied by hydronephrosis and bilateral hydroureter. In addition, the patient was diagnosed with neurogenic bladder after that. The patient was then subjected to bladder augmentation due to low-capacity bladder in September 2015. The patient in supine position, under general anesthesia, underwent a lower midline abdominal incision. After the bladder was identified, a vertical incision was made from the anterior bladder to the posterior bladder. The ileum was identified and then 20 cm long ileal segment was taken and an end-to-end anastomosis was performed. The ileal segments are then washed with normal saline and betadine solutions. Afterwards, the ileal segment is incised and is reconstructed to form a dome. The part of the ileum that had been reconstructed was anastomosed to the bladder using Monocryl 3.0 then a cystostomy was placed. The patient then underwent 2 weeks postoperative care with normal urine production and cystostomy. In the first month of postoperative follow-up, the symptom frequency was reduced to 25–30 times per day. From the pre- and post-micturition ultrasound evaluation first month after bladder augmentation, the pre-micturition bladder volume was 221 cc and the post-micturition bladder volume was 70 cc. In the second- and third-month visits, the patient conveyed reduced frequency symptoms, urinate for 15–25 times per day, and from the ultrasound evaluation, the pre-micturition bladder volume was 350 cc and the post-micturition bladder volume was 50 cc. The patient then did not come back but came back for visit in the third year. From the interview, it was found that the frequency symptoms in the first, second and third year was 6–8 times micturition per day, and at the end of the micturition the patient had to change positions and press the supra-symphysis area until it felt light. In the third year, the patient came for visit and was followed-up for clinical symptom, ultrasound, cystoscopy, VCUG and urodynamics, all of which showed good results. From VCUG examination on June 28, 2019, bladder fullness sensation was found on 250 cc bladder filling, no reflux, open bladder neck, and good sphincter. The patient had to change sitting and standing positions while pressing on the supra-symphysis area, with a urine residue of 40 cc. Cystoscopy performed on the same date showed good bladder mucosa, good ileal augmentation anastomosis to the bladder, and ureteral estuary can be identified with a bladder capacity of 350 cc (). The patient was then subjected to uroflowmetry twice on June 30, 2018, with the results of 20 s urination time, 18.8 s flow time, total urine of 544.8 cc, average flow rate of 29.1 mL / second, 41.3 s maximal flow, and 7.5 s time to maximum flow.