Urinary diversion. Patient selection and counseling

In the past 18 years, traditional methods of urinary drainage and diversion via conduits and ureterosigmoidostomy have been increasingly replaced by n ew techniques of orthotopic bladder substitution and continent urinary dive rsion. With growing knowledge of the physical and physiological relationshi ps,the more than 40 techniques of continent urinary diversion using almost all segments of the gastrointestinal tract have ceased being spectacular an d experimental. The various methods are well established, preparatory care and follow-up are standardized,and the technical and methodological aspects are sufficiently elucidated so that the underlying precept, i.e., improvem ent of these patients' quality of life, has priority.