Most patients with carcinoma of the bilharzial bladder would be good candidates for ileocaecal bladder, since the
trigone is rarely affected by the neoplasm (5.7%) and the prostate is involved in only 6% of cases. Ileocaecal bladder could also be performed in patients with non-bilharzial bladder cancer in males, even if the bladder neck is involved because the lower limit of resection in such patients could still be just above the apex of the prostate. Sixty male patients with T2 or T3 bladder cancer were divided into 2 equal groups, first group: Radical cystectomy (RC) and rectal bladder (25 case) or ilial conduit (5 cases) was done. For the 2nd group modified radical cystectomy (MRC) and ileocaecal bladder (ICB) was done. The patients were followed up for 2-5 years. Prostatic infiltration was 10% and seminal vesicle 3.3%. Postoperative mortality was 16.7% and 20% in RC and MRC groups respectively. There was suprapubic leakage in 6.6 in MRC patients; the pelvic recurrence was 28% and 25% in both groups. Diurnal continence was 79.2% in MRC group and potency was 68.2%. The preservation or improvement of renal configuration was 58% and 83.3% in both groups. The actuarial 5-year survival rate was 40% in the MRC group. Ileocaecal bladder reconstruction is an attempt to overcome the inevitable social inconveniences resulting from cystectomy and standard diversion procedures. It is therefore gratifying that most of the patients were fully satisfied with continence obtained.