Editing Muscle-Invasive Bladder Cancer (section)

====Urinary diversion====
*'''In patients undergoing radical cystectomy, ileal conduit, continent cutaneous, and orthotopic neobladder urinary diversions should all be discussed.'''
**'''<span style="color:#ff0000">Absolute contraindications to continent diversion (6):[https://pubmed.ncbi.nlm.nih.gov/28456635/ ★]</span>'''
**#'''<span style="color:#ff0000">Insufficient bowel segment length</span>'''
**#'''<span style="color:#ff0000">Inability to perform self-catheterization</span>'''
**#*Due to inadequate motor function or psychological issues
**#'''<span style="color:#ff0000">Inadequate renal function (e.g. an eGFR < 45)</span>'''
**#*Increases the risk metabolic abnormalities as a consequence of reabsorption of urine from continent diversions
**#'''<span style="color:#ff0000">Inadequate hepatic function</span>'''
**#*Increases the risk metabolic abnormalities as a consequence of reabsorption of urine from continent diversions
**#'''<span style="color:#ff0000">Cancer at the urethral margin (specifically for orthotopic neobladder)</span>'''
**#'''<span style="color:#ff0000">Significant urethral stricture disease that is not correctable (specifically for orthotopic neobladder)</span>'''
*'''<span style="color:#ff0000">In patients undergoing an orthotopic urinary diversion, a negative urethral margin must be verified</span>'''
**Risk cancer developing in the retained urethral is 1-17%, the majority of which occur within the first 2 years after surgery.
**Risk factors include: tumor multiplicity, papillary pattern, CIS, tumor at the bladder neck, prostatic urethral involvement, and prostatic stromal invasion.
***'''<span style="color:#ff0000">Although prostate involvement is the most significant risk factor for cancer in the urethra, it should not preclude orthotopic diversion, provided that intraoperative frozen section analysis of the urethral margin is without evidence of tumor.</span>''' 
**'''Preoperative prostatic urethral biopsies have not proved to be as reliable as urethral frozen sections and should not exclude patients from orthotopic diversion.'''