title: Urinary diversion: tailored solutions for individual patients.
abstract: OBJECTIVE
  Various urinary diversions are at disposition for reconstructive surgery after cystectomy. The chosen diversion has a strong impact on patients' life regarding complications and quality of life. The purpose of this review is to summarize the current tendency to adapt surgical solutions to individual needs of the patient.
  
  
  RESULTS
  Tailored surgery requires that the surgeon has been trained in the handling of all gut segments. Only in this case can he react to anatomical variants, patient comorbidities and oncological circumstances, as well as to the prognosis and the social circumstances of the patient with a tailored diversion. Changing demography and ageing populations with increasing incidence of muscle invasive bladder cancer request new, less invasive methods of urinary diversions. There is little evidence as to which is the best urinary diversion due to a lack of well designed studies.
  
  
  CONCLUSIONS
  The ileum conduit is still the most used urinary diversion worldwide. However, there are multiple techniques available to us, which guarantee the safest solution in combination with the highest quality of life for the construction of tailored urinary diversion.
authors.affiliation: aDepartment of Urology, Central Hospital of Bolzano, Bolzano, Italy bDepartment of Urology, Caritas Hospital St. Josef, Regensburg, Germany.
authors.forename: Armin
authors.initials: A
authors.lastname: Pycha
authors.forename: Maximilian
authors.initials: M
authors.lastname: Burger
authors.forename: Salvatore
authors.initials: S
authors.lastname: Palermo
mesh_terms: D015897:Comorbidity; D015653:Cystectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D011788:Quality of Life; D012307:Risk Factors; D019738:Surgically-Created Structures; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality