ABSTRACT
In 2004, bladder cancer will be diagnosed in 60240 people in the USA, 44640 men and 15600 women; 12710 will die from disease, 8780 men and 3930 women.1 Thus, women account for 26% of the cases and 31% of the deaths, which demonstrates the need for early and aggressive treatment. Radical cystectomy is the most effective means of cancer control of non-metastatic high-risk transitional cell carcinoma (TCC) of the bladder.2 An appropriate choice for urinary diversion must then be made. Orthotopic substitution in women may pose technical challenges and has previously been approached with reluctance due to concerns of urethral recurrence and urinary incontinence. Moreover, neobladder performance in women was uncertain, but now it is clear that good long-term results are achievable.3-7 Consequently, orthotopic diversion has increasingly been done in female patients. It is therefore important periodically to examine the techniques, outcome and general standard under which orthotopic substitution is done. Attention to issues of body image, fertility and functional preservation of sexual organs is critical to achieving an acceptable functional result to accompany the excellent local control that cystectomy provides in the treatment of primary bladder cancers.2
