Orthotopic neobladder is a viable option for women undergoing cystectomy for bladder cancer, with excellent oncologic outcomes and a low incidence of urethral recurrence. Careful patient selection is important, as is developing a clear understanding by the patient and her family in what to expect with an orthotopic diversion. Surgical technique is also important in optimizing functional outcomes, such as continence, sexual function, and decreased rate of vaginal fistula formation, and urinary retention.
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