Female incontinence and pelvic organ prolapse have been defined as contraindications to orthotopic bladder substitution. A 75-old-year woman with slight stress incontinence, Stage III cystocele, and vaginal vault prolapse after subtotal hysterectomy underwent radical cystectomy for Stage T2 bladder cancer. After radical cystectomy, pelvic floor integrity was restored by colposacropexy with a rectangular polypropylene mesh and an ileal reservoir to urethra was constructed. After 1 year of follow-up, she had complete daytime continence and only needed to wear a pad during the night. Her postvoid residual urine volume was constantly less than 100 mL.
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