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.
Our urologic 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.