The authors report their experience of 81 cases of bladder replacement with colonic grafts between 1980 and 1986. The operative technique is presented and its complications and functional results analysed. Bladder tumors were the most frequent indication although some cases of tuberculosis, bilharziosis and neurogenic bladder were also included. After a critical study of the literature, the authors state that the ileocecal segment has become their preferred material. Over the last fourty months, 42 patients have been treated by the latter form of bladder replacement.