Bladder reconstruction

Bladder reconstruction is surgery to make a new bladder if your bladder has been removed.

What is bladder reconstruction (neobladder)?

Bladder reconstruction is surgery to make a new bladder (neobladder) if your bladder has been removed.

Surgery to remove the bladder is called a cystectomy. You may have this as part of your treatment for bladder cancer.

Sometimes the surgeon may not be able to make the new bladder during surgery. If this happens, they make a urostomy instead. Your surgeon will talk with you about the risk of this before surgery.

How a neobladder is made

The surgeon makes the new (neo) bladder during the operation to remove the bladder. They use a piece of your bowel which they connect to your urethra. This new bladder is attached to your ureters and holds urine.

A bladder reconstruction (neobladder)

To empty your new bladder, you tighten your tummy muscles by holding your breath and pushing down into your tummy. You need to do this regularly, because you do not have the nerves that tell you when your bladder is full.

Some people may need to pass a tube (catheter) into their urethra to empty their new bladder. This is called self-catheterisation.

After surgery

After your surgery, you will have a tube (catheter) in place that drains the urine from your new bladder. This stays in place for a few weeks while you recover from the operation.

Your nurse will explain how to look after the catheter and your new bladder before you go home.

The bowel tissue used to make the new bladder continues to make mucus. This is a thick, white liquid. It might appear as pale threads in the urine. To stop this blocking the catheter, you need to flush it several times every day using fluid and a syringe. Your nurse will show you how to do this, or they can refer you to a district nurse who will help.

Before you leave the hospital, the nurse will make sure you have a supply of the equipment you need.

Living with a neobladder

Getting used to a new bladder and learning to look after it takes time. Like anything new, it will get easier with time and practice.

Having your catheter removed

A few weeks after surgery, you will return to the hospital. Some people may have an x-ray called a cystogram to examine the new bladder. A nurse or doctor will remove the catheter. You may have to stay in hospital for 1 or 2 days after this. This is to make sure your bladder is emptying fully.

Emptying your new bladder

At first, you will have to empty your bladder every 2 to 3 hours. The feeling of needing to pass urine (pee) can be different. You might find it helpful to set an alarm to remind yourself to pass urine. Over time, your new bladder will stretch and be able to hold more urine. But you may still have to empty it every 4 to 6 hours. You may also need to pass a catheter into your urethra (self-catheterisation). It helps to make sure the new bladder is completely empty. If you need to do this, your specialist nurse will show you how.

Leaking urine

To start with, you might leak urine, especially at night. But this usually gets better after a few months. Your specialist nurse or surgeon can suggest things to help. They may refer you to a continence adviser. Before your surgery, your nurse will show you how to do pelvic floor exercises. It is important to keep doing these as they can help you have more control over leaking urine.

Looking after your new bladder

As well as emptying your new bladder, you may have to wash it out. The bowel tissue used to make the new bladder continues to make mucus. This can cause an infection if it is not washed out. To do this, you put fluid through a catheter that is put into the new bladder through the urethra. Your nurse will show you how to do this.

Using public toilets

You may feel anxious about going out in public and worry about finding a toilet in time.

Planning ahead so that you are prepared can help you feel more confident. We have more information about using public toilets.