Helicobacter Pylori was previously demonstrated at gastric patch after gastrocystoplasty and a possible relationship with acid-haematuria syndrome was established after symptomatic relief by medical treatment. We present the long term outcome of a male bladder exstrophy patient after gastrocystoplasty. There was past history of bladder perforation, acid haematuria syndrome and treatment of HP and recurrent urinary tract infections, noncompliance on regular follow-up and cadaveric renal transplantation. At the preoperative evaluation for renal transplantation HP was present in the biopsy samples collected during gastroscopy and cystoscopy. The significance of persistant HP after gastrocystoplasty in the long term follow-up was discussed.