The Indiana continent urinary diversion evolved from the Gilchrist procedure. Full detubularization of the reservoir segment, tapering of the efferent limb with staples, plication of the ileocecal valve, and tunneled tenial implants have resulted in a reliable and reproducible continent cutaneous urinary reservoir. In this report the first 69 patients treated with these techniques are reviewed after a minimum 2-year followup. Overall day and night continence rates were 97% by 1 year after surgery. More than 80% of all patients are able to sleep a normal nighttime interval without catheterizing or leaking. Early plus late reoperation rates for problems related to the pouch were 17%. This rate compares favorably to other series of continent cutaneous reservoirs and even to series of ileal conduits.