The Bladder Cancer Advocacy Network presents...
Tips From Patients, For Patients:
Neobladder
After radical cystectomy to remove the bladder, the surgeon creates a new way for urine to leave the body. This new
system is called a urinary diversion. An orthotopic neobladder, usually just called a neobladder, is one type of internal urinary diversion. Some patients are not able to have a neobladder because of the extent of their tumor, their
general health, or because of other treatments they have had in the past.
Normally, urine passes from the kidneys through the ureters and into the bladder, and from the bladder through the
urethra and out of the body. After removing the bladder, the surgeon takes a segment of the small intestine and uses
it to form a new (neo) pouch for urine. This new bladder (neobladder) is attached to the ureters and the urethra, so
urine passes through it like a normal bladder. By tensing the abdominal muscles and relaxing certain pelvic muscles, the patient is able to push the urine through the urethra.
BCAN surveyed bladder cancer patients to find out what they thought patients should know about three key areas
related to getting a neobladder. These tips are their thoughts and advice.
What Questions Should Patients Ask Their Doctor About Getting a Neobladder?
1. Why is getting a neobladder a good option for me?
• What are the other urinary diversion options? • What are the benefits and risks of the neobladder?
• Why do you think this is the best option for me?
• What will happen if you decide you can’t do a neobladder during the surgery?
2. What will my life be like with a neobladder? • How much day-time and night-time incontinence can I expect? What can I do to deal with
incontinence?
• What symptoms or side effects should I look out for after the surgery?
• How long is the recovery process? What should I expect during recovery?
• How can I tell if I have a urinary tract infection?
• Can I talk to another patient who has a neobladder?
3. What is your experience with this treatment? • How many radical cystectomies have you done? How many of those have been neobladder surgeries?
• Where can I go to get a second opinion?
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What are the Most Important Things Patients Should Know About Getting a Neobladder?
1. Getting used to the neobladder will take patience, but a routine will help.
• You won’t be able to tell when your neobladder is full right away. Until you know the signs, set a
schedule and empty your new bladder regularly and completely, even at night.
• It takes focus and patience to strengthen the muscles in your new bladder and teach them how to work. The new bladder will also start out small, but as it is used, it will expand to hold more urine. • If you can’t urinate normally after the surgery, you might need to use a catheter. This is very common in women.
2. With care, you can avoid a lot of problems.
• Be prepared for incontinence at first, especially at night. Use pads to protect your mattress. Adult
diapers and pads can help during the day and at night. • Drink plenty of water during the day to keep the neobladder “flushed.” The neobladder produces
mucous, since it used to be a piece of intestine, and the mucous can build up if it isn’t flushed away regularly.
• You will have a higher risk of getting Urinary Tract Infections (UTIs). Learn how to spot infections. When you notice an infection, get treatment as soon as possible.
What are your Top Tips for Coping With a Neobladder?
1. You can live a healthy, active life with a neobladder!
• The neobladder is the urinary diversion that is most like a “normal” bladder. • Stay active and exercise!
2. Support is important.
• There are people who can help you with incontinence issues. For instance, a physical therapist can
recommend exercises like Kegels.
• Explain as much about your neobladder as you want to family and friends, and ask them for help when you need it.
• It can be helpful to talk to someone who already has the neobladder. Your doctor might be able to
connect you with someone, or you can find someone through BCAN.
3. Be aware of what might happen next.
• Now that you have a urinary diversion, you will need occasional blood tests to check your body salts and kidney function. You will also need occasional x-rays to confirm the health of your urinary system.
• You will still need regular checkups to make sure the cancer has not spread. • Your doctor may recommend chemotherapy to help prevent the cancer from spreading. BCAN provides this information as a service. Publication of this information is not intended to take the place of medical care or the
advice of your doctor. BCAN strongly suggests consulting your doctor or other health professional about the information presented.
www.bcan.org | info@bcan.org | 888-901-BCAN
Made possible by
www.bcan.org | info@bcan.org | 888-901-BCAN
a grant from