Selecting patients for continent or incontinent, heterotopic or orthotopic diversion

Radical cystectomy (RC) and urinary diversions (UDs) are difficult procedures in urology, especially when RC is performed by mini-invasive technique (laparoscopic/robotic) and UDs are tailored intracorporeally. However, RC remains the best treatment option for muscle-invasive bladder cancer (MIBC) or high-risk noninvasive bladder cancer (NIBC) [1, 2]. Different UD procedures have their own indications and may present specific problems. In experienced hands and high-volume centers with rigorous standardized preoperative selection and systematic long-term follow-up, major complications can be avoided and excellent long-term results can be achieved.