ABSTRACT
Every segment of the gastrointestinal system has been used for urinary diversion, bladder replacement or urinary tract reconstruction. The ideal bladder substitute has yet to be determined. Continent urinary diversions have traditionally been classified according to their efferent continence mechanism. Continent urinary diversions that anastomose to the urethra, using the native urethral sphincter as the continence mechanism, are termed bladder replacements, orthotopic bladder substitutes or neobladders. The ideal neobladder should allow (i) normal urethral voiding, (ii) low-pressure urine storage, (iii) preservation of renal function, (iv) socially acceptable continence, (v) no significant metabolic/nutritional disturbances and (vi) maintenance of quality of life.
