Abstract
The feasibility of orthotopic substitution of the bladder after cystectomy for cancer has been realized. One must be careful about two potential drawbacks that may appear. Cases must be selected carefully and followed up to ensure that the adoption of such a procedure does not increase the risk of local recurrences. In the long term, if overcontinence proves to be a problem among a significant proportion of such cases, the logic of and the need for orthotopic substitution are lost. One then has to reconsider that intermittent catheterization of a continent cutaneous stoma provides a better alternative.
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