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Introduction: Bladder substitution following radical cystectomy owing to malignant disease is the operation of choice for patients. We present the results of long term follow-up about the function of urinary continent pouch and orthotopic neobladder as well as the patient's satisfaction. Methods: Between March 1993 and November 2004, we have performed on 84 male patients with orthotopic ileal neobladder and on 29 patients (15 males and 14 females) with cutaneous continent urinary diversion. After radical cystectomy and lymph nodes dissection, a segment of 40-50cm length of ileum was resected and detubularized for making a pouch. Sometimes, right colon and 10cm of ileum were mobilized in case of Indiana pouch. 2 ureters were reimplanted directly or following Le Duc technique to the pouch then it was anastomosed to the urethral stump or to cutaneous diversion. Results: There were 113 patients with mean age 55,52 ± 11,95 years, suitable for the assessment: they had more than 3 years follow-up, and the required tests such as ultrasound, intravenous pyelography or CT scan, blood tests and urodynamics. The mean operative time: 352 ±23 minutes. Early complications included: 1 mortality because of intestinal leakage. 6 patients (5,31%) with urinary leakage. We had to reoperate for 1 patient with fluid collection at the pelvis and 2 patients to repair the eventration. 9 patients (10,71%) had late complications with bladder neck stricture. We evaluated the function of urinary continent pouch or neobladder every 3 months after operation. We realized that the continent pouch and neobladder had much change during the first 3-month period and they became stable after 6 month post- operation, but with the orthotopic neobladder there was slightly increase in postvoid residual urine that affected the patient.s satisfaction. Conclusions: The function of urinary continent pouch seems to be stable during the time of follow-up while the function of orthotopic neobladder has more change and has a trend to increase postvoid residual urine. The resolution is voiding education by Valsalva maneuver, contraction of the abdominal musculature or at last, self-intermittent catheterization for these patients. [ABSTRACT FROM AUTHOR]