Radical cystectomy (RC) with urinary diversion is associated with significant morbidity, much of which arises from the interposition of bowel segments in the urinary system. A tissue-engineered alternative for urinary diversion could dramatically reduce the perioperative and long-term morbidity associated with RC. Attempts at developing a tissue-engineered incontinent urinary conduit (TEUC) have involved mechanical scaffolds and promoting tissue growth within them. Despite some preclinical success, significant obstacles remain before a TEUC is ready for clinical use. A further understanding of tissue and materials engineering may help overcome these obstacles or help to develop a new approach to tissue engineering entirely.