Do you have bladder cancer? Or do you have another medical condition that keeps your bladder from working as it should? Even if you have severe urinary incontinence that won’t respond to other forms of treatment, you may want to talk to your doctor about whether a neobladder is right for you.
What is a Neobladder?
When a bladder needs to be removed, doctors make a new bladder called a neobladder, which provides a new way for urine to keep exiting naturally from the body.
The neobladder is created when a surgeon uses a piece of bowel (typically the small intestine) to form a new bladder that allows for voluntary urination. Others living with neobladders may self-catheterize through a surgically-created passage called a stoma.
Successful surgeries result in retaining urinary continence.
How to Prepare for Neobladder Surgery
While your physician will have the best advice for you regarding pre-surgery preparations, it’s good to have an idea of what to expect. Your doctor and their staff are there to educate, support, and heal you as best they can, so feel free to ask them any questions or let them know of any concerns you have about getting a neobladder.
For example, how long do they expect your recovery to take? When will you be ready to return to work or school after your neobladder surgery? Will you be put in connection with a WOCN (Wound, Ostomy, and Continence Nurse) for any post-surgery questions or help? Also, will you need to perform Kegel exercises to strengthen your pelvic floor?
Your physician may want you to learn how to self-catheterize in advance, or they may want you to wait if you will be self-cathing through a stoma. It’s not uncommon to have a clear liquid diet prescribed prior to your surgery.
Additionally, your doctor may want to carry out a kidney function test to make sure your ureters (the tubes that carry urine from the kidneys) are functioning properly.
Tell your doctor about any allergies or medications, including blood thinners. Be sure to talk with your doctor and ask questions, so you feel ready for your neobladder surgery.
What to Expect After Your Neobladder Surgery
During surgery, you will have your original bladder removed. Typically, a piece of your bowel will be formed into a pouch to act as your new bladder. Just like a normal bladder, a neobladder works to collect urine inside the body until it’s time to void.
However, living with a neobladder may be somewhat different.
First of all, a regular bladder has nerves that provide a sensation alerting someone when they need to urinate. The sensation with your neobladder will not be quite the same. Instead, you may feel full, as you might after a large meal.
Common post-surgery side effects include temporary urinary incontinence. You may want to discuss the best options for incontinence management with your doctor as you heal.
Irrigating Your Neobladder
Because the neobladder is constructed from the bowel, you will likely need to self-irrigate your new neobladder.
Your doctor will let you know how to manage this process and how often to do it. Typically, it will be a few times per day or it may only be weekly. Irrigation of your neobladder will help clear any mucus build-up.
The neobladder irrigation process may require additional items with your intermittent catheter order, such as a saline solution and a syringe.