Orthotopic diversion in women.

An orthotopic neobladder has quickly become the preferred diversion after cystectomy in most women. The decision to proceed with a cystectomy for high-grade, superficially invasive transitional cell carcinoma is frequently difficult for the patient and physician alike. The availability of an orthotopic diversion to provide an excellent voiding pattern and continence may tip the scale toward earlier cystectomy with anticipated excellent cancer control.