Prior to the introduction of the ileal conduit more than four decades ago, the options for
urinary diversion after cystectomy were extremely limited. Direct cutaneous anastomoses of
the collecting system (cutaneous pyelostomies, ureterostomies) offered patients a short-term
diversion, but the benefits were outweighed by significant complications: recession or
stenosis of the stoma. The first choice of diversion was the ureterosigmoidostomy with or
without antireflux technique. Then it fell in popularity and was replaced with
continent/non-continent uretero-ileo-cutaneous diversions. Only in the last years the
continent orthotopic neobladder has been widely employed as first procedure choice. At
present, patients can be offered a non-continent cutaneous diversion, a continent cutaneous
diversion or an orthotopic neobladder urinary reconstruction
