These continent urinary tract reconstructions involve creation of a spherical neobladder from bowel that is connected either to the urethra to replicate volitional voiding, or to a small skin opening that requires intermittent catheterization to empty the reservoir. Advantages of the ileal conduit include a shorter operative time and relative ease of the surgical technique. Advantages of the neobladder include continence and preserved body image.
Despite the presumed benefits inherent in a continent urinary diversion, analysis of nationally representative data reveals significant disparities in the utilization of continent reconstructions.1,2 Among patients who underwent radical cystectomy for bladder cancer between 1992 and 2001,