Transitional cell carcinoma (TCC) in the urinary tract is characterized by the development of multiple tumors in time and space. When cystectomy is performed, urinary tract is reconstructed by various options including a neobladder using patient’s own intestine anastomosed to the urethra. This procedure assures normal voiding from the urethra even after cystectomy. Use of the urethra for preserving urethral voiding and function of a neobladder are reviewed from viewpoints of carcinogenesis and quality of life after cystectomy. Incidence of subsequent urethral cancer arising after cystectomy is relatively high, however, if high risk patients are appropriately excluded, a neobladder can be constructed safely from the oncologic standpoint and patient’s quality of life.

(Communicated by Takashi SUGIMURA, M. J. A., Sept. 12, 2003)