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Continent ileal neobladder urinary diversion: as an alternative to ileal conduit diversion.

Total bladder replacement with an ileal neobladder was performed in five male patients undergoing cystoprostatectomy. The surgical technique and short-term results are reported. Four of these patients exhibited total urinary continence day and night. One patient was totally continent during the day but had difficulty with continence at night due to mucus leakage. All patients demonstrated satisfactory bladder emptying (average post-micturition residual < 40 mL) with a flow rate of 4-15 mL/s. Until 1989 the ileal conduit, first described by Bricker in 1950, was used as the preferred method of urinary diversion. We believe that the ileal neobladder in male patients is an excellent bladder substitute with an associated low operative and peri-operative morbidity and a high long-term continence rate, allowing the patient to be free from urostomy.