Objective   To present our initial experience and results of the laparoscopic radical cystectomy (LRC) with orthotopic ileal neobladder in women patients with bladder carcinoma.     Methods   From February 2003 to September 2008

we performed laparoscopic radical cystectomy with orthotopic ileal neobladder in 19 women patients with bladder carcinoma (13 patients undergoing hysterectomy and ovariectomy

6 patients having internal genitals preserved). The major procedures included standard pelvic lymphadenectomy

radical cystectomy with genital resection or genital preservation

extracorporeal construction of “M” shaped ileal neobladder and the anastomosis of ureter-neobladder through a 4-5 cm midline subumbilical skin incision

and laparoscopic urethra-pouch anastomosis. After the surgery

all the patients were followed up. The perioperative data

urodynamic analysis

the residual urine volume

and the recurrence of tumor were recorded.     Results   The operation time and the blood loss were (340.5±43.1) min and (353.9±71.3) ml

respectively. A follow-up for 2 to 69 months showed micturition in all patients in half a year

but occasional daytime urinary incontinence in 1 case

nighttime incontinence in 2 cases

and voiding difficulties in 3 cases 1 year later. The volume of neobladder was (333.6±45.4) ml and the residual urine volume was (41.2±18.1) ml (0 to 210 ml)

respectively. The neobladder was in the pelvic with the shape

size

and location similar to the original one in cystourethrography. Postoperative complications included urethra-pouch anastomose stenosis in 1 case and pouch-vaginal fistula in 1 case. Bone metastasis was found in 2 cases during the follow-up.     Conclusion   Laparoscopic radical cystectomy with orthotopic ileal neobladder in women patients is a technically feasible surgery which can cure patients with reservation or removal of internal genitals

and has the advantages of less blood loss and less trauma. Most female patients are able to urinate. However

urinary incontinence and voiding difficulties rate are slightly higher than those found in male patients. Long term follow-up is needed to evaluate the new bladder function and tumor control.