Purpose of Review: Transient urinary retention is a known complication of bilateral extravesical ureteral reimplantations. Recent studies have shown that the robotic-assisted bilateral extravesical reimplantation may have lower transient urinary retention rates than previously reported for the open approach. The purpose of this review is to compare urinary retention incidence in patients undergoing open versus robotic-assisted extravesical reimplantations. Recent Findings: In some of the larger series, open bilateral extravesical ureteral reimplantation was noted to have a temporary urinary retention rate of 4–15%. In our recent experience with the open approach, we have noted a 2% incidence of transient urinary retention. In recent series of robotic-assisted bilateral extravesical reimplantations, transient retention was seen in 0–22%, with larger series favoring lower urinary retention rates. Summary: The incidence of transient urinary retention following open or robotic-assisted approaches in recent series is 0–2%, which is almost negligible. Dysfunctional elimination syndrome symptoms and constipation need to be aggressively treated preoperatively. Families of patients who undergo bilateral extravesical ureteral reimplantations, regardless of whether it is performed via the open or robotic-assisted approach, should not only be counseled of the small risk of transient urinary retention but should also be told that this can also be seen with any other surgical approach for the repair of primary vesicoureteral reflux.