The evolution of the ileal segment bladder substitution operation

The historical background and events leading to the development of ileal conduit bladder substitution are reviewed. The reported results of twenty-five years experience with the operation are discussed with special reference to the early and long-term complications and risk to renal function. The importance of continued efforts to minimize these risks, especially when the operation is done in children and for benign disease, is emphasized. It is suggested that some of the more promising variations in the operation should be set up as prospective studies in order that meaningful comparisons may be possible in the future.