Evolution and progress in bladder replacement

Nowadays, the first choice after radical cystectomy both in male and in female patients is no more urinary diversion, but bladder replacement surgery through orthotopic reconstruction. In 2006 we carried out a mail interview among Italian Urology Departments about urinary diversions and orthotopic neobladders; the choice for orthotopic neobladder had increased compared to a previous interview administered five years before. As far as the type of orthotopic neobladders are concerned, it was evident that Italian urologists prefer to use the ileal reservoir, preferably the Studer's neobladder, followed by VIP; the use of Camey II is decreasing while Y-neobladder has gained many consents, being preferred to Hautmann's reservoir. The findings of this interview suggest that the ideal orthotopic neobladder hasn't been proposed, yet, and that Italian urologists are still looking for easier and more reliable solutions.