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.

About

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.

Candidates

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.

  • Collaboration. At Mayo Clinic, urologists work closely with specialists in medical oncology and radiation oncology to ensure that you receive the most comprehensive and supportive care possible. Other professionals are included as needed.
  • Experience. Mayo Clinic's highly skilled urologic surgeons have been creating neobladders after cystectomy for almost 25 years.
  • Expertise. Neobladder reconstruction is a complex procedure that requires highly skilled and extensively trained surgeons. Mayo Clinic doctors are specially trained in urologic procedures in order to provide you with the best care.
  • Access to the latest. Mayo doctors are leaders in urologic clinical research, including examining the most effective techniques for creating neobladders. This research enables Mayo Clinic to offer the most advanced urologic treatments available.
  • A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Learn more about bladder cancer.

Mayo Clinic in Rochester, Minn., Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic in Phoenix/Scottsdale, Arizona, neobladder reconstruction is performed by specialists in urology. Your comprehensive care team may also include specialists in medical oncology and radiation oncology, as well as nursing experts in neobladder care.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Jacksonville, Florida, neobladder reconstruction is performed by specialists in urology. Your comprehensive care team may also include specialists in medical oncology and radiation oncology, as well as nursing experts in neobladder care.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

At Mayo Clinic in Rochester, Minnesota, neobladder reconstruction is performed by specialists in urology. Your comprehensive care team may also include specialists in medical oncology and radiation oncology, as well as nursing experts in neobladder care.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Cancer research is conducted in coordination with the Mayo Clinic Cancer Center. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.

Mayo Clinic doctors and researchers in the Department of Urology are actively involved in research on the technique and outcomes of neobladder reconstruction. Research examples include:

  • Assessing outcomes after neobladder reconstruction to better understand the procedure's safety and long-term effectiveness
  • Development of new bladder substitutions that don't require the use of a bowel segment
  • Evaluation and refinement of new technologies, including optimal use of laparoscopy and the surgical robot

Mayo Clinic is a member of the Alliance for Clinical Trials in Oncology, a national clinical research group that conducts top-quality trials aimed at controlling, treating and preventing cancer.

See a list of publications by Mayo Clinic doctors on neobladder on PubMed, a service of the National Library of Medicine.

Jan. 15, 2015