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Abstract Orthotopic bladder after Radical Cystectomy represents a complex process that attempts to maximize health-related QOL for patients after surgery. In a well-selected patients, the creation of an orthotopic neobladder allows the elimination of an external stoma and preservation of body image without compromising cancer control. However, it is a long procedure and associated with a high rate of early and late complications and mortality and low quality of life in patient with bad functional outcomes Careful patient selection is the key to obtain good results from this procedure. Also patient preoperative counseling regarding the potential side effects of incontinence and high rate of complication and longer and more rigorous postoperative recovery compared with incontinent diversions, those are a very important part in decision making to have an orthotopic diversion |