New trends in the surgical management of invasive bladder cancer.

Radical cystectomy with urinary diversion is one of the most complex urologic procedures and is associated with significant morbidity and mortality. Although it remains the gold standard for treatment of advanced localized disease, survival has not changed substantially over the preceding decades, and high complication rates and prolonged hospital stays remain common. However, recent years have seen the development of robotic-assisted radical cystectomy, trials on the benefit of extended lymph node dissection, and evidence supporting the role of Enhanced Recovery After Surgery protocols. This article reviews recent trends in surgical management of muscle-invasive bladder cancer.