TABLE 77.1 SELECTION CRITERIA FOR ORTHOTOPIC BLADDER SUBSTITUTION
renal reserve. An absolute contraindication to continent urinary diversion is a compromised renal function as a result of chronic renal failure or long-standing ureteral obstruction. Some patients with preexisting renal failure due to ureteral obstruction caused by their primary bladder cancer may recover sufficient renal function to allow for continent diversion once the obstruction is relieved. Placement of a percutaneous nephrostomy tube before surgery in these patients may provide a more accurate estimate of the true renal function. Currently, an estimated glomerular filtration rate of 50 mL/min is considered the lower limit so as to prevent the need for lifelong alkaline supplementation.