The evolution of urinary diversion has been remarkable, especially during the last decade. Although the ideal form of urinary diversion remains to be developed, currently the continent orthotopic reservoirs most closely resemble the normal voiding pattern following cystectomy. Lower urinary tract reconstruction to the urethra has not been performed in women, because urethrectomy has been routine, making orthotopic reconstruction impossible. The excellent results achieved with bladder replacement in men following radical cystectomy have stimulated a re-evaluation of our practice in women requiring lower urinary tract reconstruction in the hope of providing the most functional, attractive reservoir after cystectomy.

When considering women for orthotopic lower urinary tract reconstruction, three important criteria must be fulfilled:

If these three criteria can be safely maintained, female bladder cancer patients may be considered appropriate candidates for orthotopic urinary tract reconstruction.