title: Management of Voiding Dysfunction After Female Neobladder Creation.
abstract: OBJECTIVE
  Functional complications after orthotopic neobladder urinary diversion (ONB), including urinary incontinence and urinary retention, present unique challenges. The purpose of this review is to outline contemporary treatment options for voiding dysfunction after ONB in females.
  
  
  RESULTS
  Meticulous surgical technique in the form of urethral nerve-sparing has been shown to play an important role in maintaining continence, as has sparing the uterus when possible. Data supporting the effectiveness of lifestyle measures, urethral bulking, pubovaginal slings, and transobturator slings in the treatment of urinary incontinence are widely variable and limited to case reports. Urinary retention is still most effectively managed with self-catheterization. Voiding dysfunction after ONB can be devastating. Recent advances focus on improving surgical techniques to decrease the risk of incontinence and retention, as post-operative management options are limited.
authors.affiliation: Division of Urology, University of Alberta, Edmonton, AB, Canada.
authors.forename: Nathan Y
authors.initials: NY
authors.lastname: Hoy
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA. joshua.cohn@vanderbilt.edu.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Cohn
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA.
authors.forename: Casey G
authors.initials: CG
authors.lastname: Kowalik
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA.
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Kaufman
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA.
authors.forename: W
authors.initials: W
authors.lastname: Stuart Reynolds
authors.affiliation: Department of Urologic Surgery, Vanderbilt University Medical Center, 1302A Medical Center North, Nashville, TN, 37232, USA.
authors.forename: Roger R
authors.initials: RR
authors.lastname: Dmochowski
mesh_terms: D015653:Cystectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy; D016055:Urinary Retention / Q000209:etiology / Q000628:therapy; D014555:Urination Disorders / Q000209:etiology / Q000628:therapy*
keywords: Female; Orthotopic neobladder; Radical cystectomy; Urinary incontinence; Urinary retention; Voiding dysfunction