Rebuilding the lower urinary tract after cystectomy: a roadmap for patient selection and counseling

Numerous options exist for reconstructing the lower urinary tract after radical cystectomy. Deciding between continent and noncontinent urinary diversion can be challenging for both physician and patient. This process should be logical and should integrate factors including the patient's malignancy, comorbid disease, functional status, and personal preference. Thorough patient education and a delicate balance between risk and benefit are critical to the success of any strategy for urinary diversion. This review presents a basic algorithm for planning reconstructive options and counseling patients before cystectomy.