We report the first Finnish patient with carcinoma in an augmented intestinal bladder, where urine and stools are not in contact. The patient had undergone rectal bladder reconstruction at the age of 2 years because of bladder exstrophy. When the patient was aged 46 years, a 2-cm, papillar, well-differentiated adenocarcinoma was detected and removed, preserving the rectal bladder.