Objective: Orthotopic bladder replacement after cystoprostatectomy has
long become the method of choice in the treatment of infiltrating bla
dder cancer in males. Very good quality of life in patients thus treat
ed stimulated the work on a similar approach applicable to females. Me
thods: Twelve females were treated by urethra-sparing cystectomy. The
surgical technique preserves not just the urethra itself but also the
pelvic floor and relevant innervation. Results: Diurnal continence was
achieved in 11 patients, 1 of whom had a so-called hypercontinence wi
th a residual volume of 300 mi. The remaining patient suffered from st
ress incontinence. Conclusion: The described urethra-sparing radical c
ystectomy in female patients with a urothelial tumor, with normal pelv
ic floor and with a low risk of secondary affection of the urethra, pe
rmits reconstructing a continent orthotopic neobladder from a detubula
rized intestinal segment.