Editing Orthotopic Urinary Diversion (section)

== Follow-up for patients with orthotopic diversion ==

* '''There is no consensus on the ideal follow-up regimen for patients with orthotopic diversion.'''
* '''The follow-up regimen can be divided into 3 time segments:'''
*# '''Early evaluation (first 4 months) to identify early ureteroileal anastomotic strictures caused by technical difficulties or poorly vascularized distal ureters.'''
*# '''Middle period (4 months to 3 years) primarily focused on detecting cancer recurrence.''' This is best managed with CT or other cross-sectional imaging, which also allows evaluation of the upper tracts and reservoir for stones or obstruction. The frequency of the follow-up can be risk-adapted according to the pathologic findings at the time of cystectomy and the risk of subsequent recurrence.
*# '''Long-term follow-up (beyond 3 years) to detect pouch stones, late upper tract obstruction, and urothelial carcinoma arising in the urethra or upper tracts.'''
* Follow-up should include rectal and pelvic examination and urethral cytology to identify urethral recurrence, which occurs in ≈10% of males and rarely in females