During the last decades, orthotopic bladder substitution (OBS) after radical cystectomy for bladder cancer in women has been increasingly proposed. Meanwhile, strict patient selection criteria, improved surgical techniques, long-term follow-up in large patient cohorts, and validated evaluation have defined the role of OBS in men. Several issues must be clarified in women: oncological outcome, complication rates, functional results, quality of life, and sexual function. As a matter of fact, the results of OBS in women are substantially unchanged in the last decade as stated in this paper.From the oncological standpoint, the patient outcome seems objectively satisfactory but selection criteria are different in the published series. Fortunately, the problem of urethra recurrence seems less relevant in properly selected patients.
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