THE ILEAL NEOBLADDER TO THE FEMALE URETHRA

Our surgical and functional experience with orthotopic bladder replace ment in women is presented. Urethral support sparing cystectomy and th e ileal neobladder as reservoir guarantee excellent continence in all patients. Retention in 20% to 30% of patients is the critical issue, r ather than the expected incontinence. The advent of orthotopic lower u rinary tract reconstruction in women is a major achievement in the evo lution of urinary diversion. With our increasing understanding of the continence mechanism in women, and with increasing evidence that the f emale urethra can be safely preserved after cystectomy, orthotopic low er urinary tract reconstruction (by the ileal neobladder) can be offer ed safely, not only to men but also to women undergoing cystectomy.