Bladder cancer is a relatively rare malignancy; however, women are more likely to present with muscle invasive disease and require radical cystectomy. Radical cystectomy is a life-altering operation, requiring thoughtful consideration of both urologic and gynecologic organs. In order to improve the standard of care for women undergoing radical cystectomy, urologists should adopt a thorough, patient-centered approach to surgical planning. This narrative review provides a review of the extant literature pertaining to the management of gynecologic organs in women undergoing radical cystectomy, including the management of the cervix, uterus, and adnexa.