RT Book, Section A1 Donahue, Timothy A1 Bochner, Bernard H. A2 Bristow, Robert E. A2 Chi, Dennis S. SR Print(0) ID 1115055430 T1 Continent Diversions T2 Radical and Reconstructive Gynecologic Cancer Surgery YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071808095 LK obgyn.mhmedical.com/content.aspx?aid=1115055430 RD 2024/03/28 AB Urinary diversion following cystectomy remains one of the great challenges of radical pelvic surgery because an equivalent replacement for the native bladder has yet to be developed. The bladder is ideally a low-pressure, highly compliant reservoir for the storage of urine with its own intrinsic continence mechanism, sensation, and coordinated, volitional emptying by muscular contraction. In addition, the bladder is generally impermeable, stores sterile urine, and possesses antirefluxing ureters to protect the kidneys and upper tracts from sustained increases in bladder pressure. Recapitulating many of the intrinsic properties of the native bladder and understanding the impact of the choice of bowel segments are paramount to successfully reconstructing the urinary tract. Urinary diversions are broadly divided into 2 main categories: continent and incontinent diversions. In this chapter, we will review the principles, surgical technique, perioperative management, and long-term issues associated with continent cutaneous reservoirs. The other major type of continent diversion, orthotopic urinary diversion is described in Chapter 13.