If you have bladder cancer that has invaded the deeper layers of the bladder wall or if you've had recurrent bladder tumors, you may require removal of your entire bladder (cystectomy) to control the disease.
Once you have made the decision to have your bladder removed, you and your doctor will discuss how to control the urine that your body needs to eliminate. For some patients, a surgical procedure to construct a new bladder (neobladder reconstruction) may be an option.
To create a neobladder, your surgeon first removes your cancerous bladder (cystectomy) through either a traditional abdominal incision or with a robotic-assisted laparoscopic approach. Your surgeon then must isolate and reshape a section of your small intestines. This section of intestine is made into a spherical shape and becomes the neobladder.
Your surgeon then 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, allowing you to maintain urinary control with a functional bladder capable of storing urine without the need for external bags or appliances.
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.
If you require complete bladder removal, you may be a candidate to have a neobladder reconstruction. Determining if this procedure is right for you depends on several factors, such as:
- Your age and overall health, particularly your kidney function
- Extent of your bladder cancer
- Previous radiation or surgery to the bladder or prostate, which may affect the ability of the bowel to heal correctly after creation of a neobladder
- Your willingness to deal with catheters and tubes after surgery
Your doctor will review the risks and benefits of neobladder reconstruction with you and will discuss whether you're a candidate for this procedure. Neobladder surgery is not an option if you have cancer of the urethra.
Jan. 15, 2015
- Wein AJ, et al. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed Oct. 30, 2014.
- Boorjian SA (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 6, 2014.
- Tollefson MK (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 6, 2014.
- Shariat SF, et al. Urinary diversion and reconstruction following cystectomy. http://www.uptodate.com/home. Accessed Nov. 6, 2014.