Objective: To summarize the surgical experience of total cystectomy ileal neocystectomy. Methods: There were 12 cases in this group, 10 were patients with bladder cancer and 2 with tuberculous contracture of the bladder. There were 9 male cases and 3 female cases. The ages ranged from 21 to 73 years, with an average of 53 years. There were 8 cases with multiple infiltrative bladder tumor growth, 2 patients with triangular growth and wide base, all 10 cases were metastatic epithelial cell carcinoma, 3 cases were grade 2 and 7 cases were grade 3. The bladder capacity of the 2 tuberculous patients was less than 50 ML and anti-TB treatment was more than 2 months in all cases. After radical cystectomy, 40-50 cm of ileum was intercepted at 10 cm from the ileocecal area, the free intestinal canal was flushed, the intestinal canal was placed in a “W” shape, the whole layer was split longitudinally against the intestinal canal of the mesenteric margin, the intestinal piece was sewn into a “W” shaped intestinal disc, and the left and right sides of the intestinal disc were sutured together to form a new bladder. The intestinal pieces were sewn into a “W”-shaped intestinal disc, and the left and right sides of the intestinal disc were sutured together to form a new bladder. The ureter was implanted into the new bladder for 1.0-1.5 cm, and a 1 cm diameter circular hole was cut at the lowest part of the new bladder to anastomose with the tip of the prostate, leaving bilateral ureteral stent tubes or DJ tubes and a new cystostomy tube. Results: In all cases, the bilateral ureteral catheters were removed at 2 weeks postoperatively or the DJ tubes in the ureter were removed bilaterally at 2 months postoperatively, and the ureter was removed 12 to 121 d postoperatively. At a follow-up of 2 months to 4 years, urodynamic examination showed a new bladder volume of 253-592 ml (mean 321 ml), a maximum internal pressure of 15-26 cmH2O (mean 20 cmH2O) at bladder filling, a voiding bladder pressure of 44-65 cmH2O (mean 49 cmH2O), a mean maximum urinary flow rate of 16 ml/s, and a residual urine of 0-123 ml (mean 23 ml). 23ml). Two patients with posterior urethral stricture were able to urinate normally after urethral dilatation. All 12 cases in this group had no hydronephrosis, no ureteral bladder reflux and normal renal function by ultrasound and intravenous urography. There were no new ileal bladder tumors or urethral tumor recurrence after surgery. One patient had hyperchloremic acidosis at one month after surgery, which improved after symptomatic treatment, and all patients urinated spontaneously without catheterization. CONCLUSIONS: Ileal neobladder is a low complication bladder replacement procedure for patients with bladder tumors that do not invade the prostate or urethra and for patients with tuberculous contracture of the small bladder. Its newly created urinary storage bladder (neobladder) has the advantages of large capacity, low internal pressure, high compliance, self-voiding, consistent with physiological voiding, and high quality of life for the patient.