The most commonly employed urinary diversion operations are associated with a high incidence of complications and the disadvantage of requiring an external appliance to collect urine. The Kock continent ileal reservoir, introduced in 1975, provides an intraabdominal receptacle for storage of urine and two nipple valves which maintain continence and prevent ureteral reflux. The reservoir is emptied by self-catheterization; no external appliance is necessary. This operation provides a more ideal substitute for the lower urinary tract than any other urinary diversion procedure thus far reported. The seven patients reported herein have been followed for up to 3 years and enjoy completely continent ileal reservoirs. Follow-up studies have demonstrated that the kidneys are adequately protected from ureteral reflux and ascending infection. Metabolic acidosis has presented no serious problem. All of the patients enjoy a far better quality of life since discarding their external appliances.