Experience is reported on more than 700 patients submitted to rectal bladder over the last 20 years. The main indications were total cystectomy due to bladder neoplasias and palliative surgery in patients in whom cystectomy was impossible. The rectal bladder, even of the Mauclaire type, is the most useful and best accepted urinary diversion. Separation of urime from faeces avoids serious ascending infections and involvement of renal function. These observations are supported by the long survival of patients submitted to derivative surgery in the absence of neoplastic disease.