Before the procedure
Your doctor orders tests to check your kidney function and to make sure that you don't have a urinary tract infection. You may also have an imaging test, such as a CT scan, of your urinary tract to check the ureters — tubes that carry urine from the kidneys to the bladder — to see that they are in good condition.
During the procedure
To create a neobladder, your surgeon first removes your cancerous bladder (cystectomy) through either a traditional abdominal incision or with a robot-assisted laparoscopic approach (robotic surgery). Your surgeon then reshapes a section of your small intestine, colon or a combination of the two into a sphere, which becomes the neobladder.
Your surgeon places the neobladder in the same location inside your body as your original bladder. The neobladder is attached to your ureters so that urine can drain from your kidneys into the neobladder. The other end of the neobladder is attached to your urethra. This allows you to maintain urinary control with a functional bladder capable of storing urine without the need for external bags or appliances.
After the procedure
The hospital stay after neobladder reconstruction is usually about three to five days.
As with any bladder substitute, it may take some time until the neobladder functions best. Immediately after surgery, many people may have difficulties with urinary incontinence until the neobladder stretches to a normal size and the muscles that support it get stronger.
Daytime continence usually improves over the first three to six months after surgery, though it may continue improving for up to 12 months. Nighttime continence may take slightly longer, and can keep improving into the second year.
Lifelong follow-up is necessary after a neobladder reconstruction. Ask your doctor how often you should plan to return for follow-up visits.