Urinary diversion with continent urinary reservoirs to the urethra offer major advantages to patients with invasive bladder carcinoma. Multiple configurations for pouch creation have been described, however, there are unifying concepts between all types of continent diversions which should be adhered to in order to optimize outcome. These general concepts are discussed and the author's technique for small and large intestinal neobladder construction is presented. Perioperative management is delivered using a collaborative care critical pathway technique and has resulted in excellent outcomes.