Bladder substitution in women

Although numbers are still small and followup is often limited, female orth otopic bladder reconstruction has been shown to provide excellent, near-nor mal voiding and storage function in selected patients, and its popularity h as been growing over the last decade. The true role of this form of surgery , however, is not yet fully established. This paper discusses the indicatio ns for patient selection, operative technique and outcome of female bladder substitution. Outcome is equivalent to that seen in male patients, althoug h in some series there is a higher rate of voiding dysfunction requiring in termittent self-catheterization. Although further data regarding urethral r ecurrence rates are awaited, it would seem that with careful patient select ion and operative technique, cancer surgery may not be compromised. Functio nal results have been excellent and patient satisfaction is very high. Prov ided there is a functional external sphincter and tumor margins can be safe ly cleared, this form of surgery offers patients the best opportunity to pr eserve quality of life following cystectomy.