Which statement is true about orthotopic neobladder?

• A. It bypasses the urethra for drainage
• B. It uses a reservoir created from stomach tissue and attached to the urethra
• C. A reservoir is created from bowel and attached to the ureters and urethra
• D. It is always an incontinent diversion through a stoma

Answer: (C)

Orthotopic neobladder uses a segment of bowel to form a new bladder that sits in the pelvis, then connects the ureters to this reservoir and the distal part to the urethra. This creates a continent storage that can be emptied through the natural urethral outlet, allowing voluntary voiding in many patients. The tissue used is bowel, not stomach, and the drainage path remains through the urethra rather than a stoma. As a result, it's not an incontinent stoma diversion. The ureters and urethra are the key connections in this reconstruction.