Bladder reconstruction
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.
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
Having your catheter removed
Emptying your new bladder
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
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.