Radical cystectomy: Posterior dissection following prior therapy

In summary, we emphasize three useful points of technique for difficult radical cystectomies: (1) sharp dissection under direct vision in the plane between the posterior leaf of Denonvilliers fascia and the anterior rectal wall, (2) use of the vas deferens as a guide to the seminal vesicles, and (3) a combined retrograde and antegrade dissection.