Patients with locally aggressive bladder
cancer may need to undergo surgical removal of the bladder, a
procedure called a radical cystectomy. There are a number of options
for managing the urine after this procedure. Many men and women who
have this surgery are potential candidates for bladder reconstruction
with a neobladder.
How does a neobladder work?
The neobladder is made from a piece of a person’s own small
intestine that is formed into a pouch and positioned inside the body
in the same position as the original bladder. With this procedure,
most patients can void normally. There is usually a period of urinary
leakage until the pouch stretches up and the patient strengthens the
sphincter muscle that holds in the urine. Occasionally patients need
to put in a catheter to drain the urine; this is more common in women
than in men. Some patients also have persistent leakage, especially at night.
Not everyone is a candidate for a neobladder reconstruction; for
example, patients must have full kidney and liver function, and cannot
have cancer in urethra. However, many patients prefer this type of
diversion compared to an ileal conduit (external collecting bag that
sticks to the abdominal wall).
Stanford expertise in neobladder reconstruction
Many years ago, Dr. Faud Freiha developed the 'Stanford pouch'—one
of the early forms of neobladder. Currently, all of the urologic
oncologists at Stanford Health Care have experience performing
neobladder reconstruction. Dr. Eila
Skinner, who joined the Stanford faculty in 2012, has extensive
experience with continent urinary diversion that spans over 20 years.
oncology experts discuss options for urinary diversion with each
patient and, together with the patient and family, arrive at a
decision on the best choice for that person. The caring staff at the
Stanford Cancer Center can help you recover from surgery and teach you
how to use your new bladder.