Authors review their early experiences and the oncopathological relations in respect to 25 cases of radical cystectomy involving orthotopic bladder substitution. The difficulties of diagnostics and indication are discussed. Attention is drawn to the fact that pathological "staging", "grading" are not entirely exact and reliable, though surgical indication is positioned on these. It is the opinion of authors that in case of TIG3 radical surgery is indicated. Due to the shortness of the follow-up periods, no studies on survival were performed. It remains an open question whether radical cystectomy is indicated as opposed to the possible choice of organ-preserving surgery.