A major contraindication to continent urinary diversion is poor renal function and a contraindication to bladder substitution with an ileal neobladder is creatinine level greater than 2.5 mg.ldl.1 Patients with serum creatinine greater than 1.5 mg./dl. have not been considered good candidates for a rectosigmoid pouch.2 We report presemation of renal function in a patient with renal compromise using a reservoir that incorporated gastric and ileal segments. Our preliminary results show that the gastroileal neobladder may be an alternative method of urinary diversion in the presence of poor renal function when it is believed that the ileocolonic segment cannot be used. CASE REPORT