Internai urinary diversions date back more than 100 years to when ureterosigmoidostomy was introduced by Simon. Urinary diversion to the rectum is a simple technique of continent urinary diversion but can cause troublesome complications such as electrolyte imbalance, pyelonephritis and renal function deterioration. Improvement of the techniques of internai urinary diversion have reduced the risk of such complications. When the urethra cannot be preserved, internai urinary diversion provides a viable alternative to external diversion.