Abstract

Patients who undergo radical cystectomy for bladder cancer require reconstruction of the lower urinary tract. Orthotopic neobladder in carefully selected patients offers a more physiologic way of voiding. However, daytime and nighttime incontinence are commonly seen in male and female patients following surgery. Evaluation of incontinence requires careful history and physical exam to differentiate stress urinary incontinence from neobladder-vaginal fistula or poorly compliant neobladder with hypercontinence. Treatment of incontinence in patients with ONB may include: placement of retropubic sling, artificial urinary sphincter, or repair of fistula when present.

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