Why Might Someone Need a Neobladder?

A neobladder is a urinary diversion created after the bladder is removed, most often during surgery for muscle-invasive bladder cancer. It may be an option for people whose cancer has not involved the urethra and who have good kidney function and overall health. Not everyone is a candidate, so the decision depends on several medical factors.

What is a Neobladder?

A neobladder is a type of urinary diversion created after the bladder has been removed following a radical cystectomy. 

During neobladder surgery: 

1. The surgeon removes the bladder. 

2. A section of the small intestine is taken and reshaped into a pouch. 

3. The new pouch is connected to the ureters and urethra. 

4. Urine collects in the neobladder and leaves the body through the urethra. 

Unlike an ileal conduit, a neobladder allows urine to remain inside the body until the patient is ready to empty it. 

Feature	Neobladder
Uses intestine to create new bladder	Yes
Requires radical cystectomy	Yes
Urinates through urethra	Usually
Requires external bag	No
Require self-catheterization	Sometimes
Recovery and training needed	Yes

Why Might Someone Choose a Neobladder? 

A healthcare team may recommend a neobladder when: 

• The bladder must be removed. 

• The patient wants a continent urinary diversion. 

• Kidney function is adequate. 

• The urethra can safely be preserved. 

• The patient is healthy enough for a longer, more complex surgery. 

Not everyone is a candidate. Factors such as tumor location, prior treatments, kidney function and overall health may make another urinary diversion a better choice.

How Is a Neobladder Created?

After bladder removal, surgeons use a part of the small intestine to build a new urine storage pouch. 

The neobladder is then connected to: 

• The ureters, which carry urine from the kidneys. 

• The urethra, which allows urine to leave the body. 

Because intestinal tissue behaves differently than bladder tissue, patients must learn new techniques for emptying the neobladder. 

What Are the Benefits of a Neobladder?

Some patients choose a neobladder because it offers greater independence and a more natural urinary function. 

Benefits Include: 

• No external urine collection bag 

• No permanent stoma on the abdomen 

• Ability to store urine internally 

• Greater control over when to urinate 

• Potential improvement in body image 

• Ability to do many normal activities, including travel and exercise. 

Many patients return to active lifestyles after recovery. 

What Are the Risks of Neobladder  Surgery? 

Like all major surgeries, neobladder surgery carries risks. 

Potential Risks Include: 

• Infection 

• Bleeding 

• Blood clots 

• Urinary leakage 

• Urinary retention 

• Electrolyte imbalances 

• Vitamin B12 deficiency 

• Urinary tract infections 

• Incontinence

• Need for intermittent catheterization 

Patients should discuss individual risks with their urologic surgeon. 

How Do You Prepare for Neobladder Surgery?

Before surgery, your healthcare team may recommend: 

• Reviewing medications and supplements 

• Stopping certain medications temporarily 

• Following food and drink restrictions 

• Completing pre-operative testing 

• Planning for recovery and support at home 

Following your surgeon’s instructions can help reduce complications. 

What Is Recovery Like After Neobladder Surgery

During Recovery: 

• A catheter is often needed for several weeks. 

• The neobladder starts small and gradually expands. 

• Patients learn new techniques to empty the bladder. 

• Pelvic floor exercises may improve control. 

• Nighttime urination is common early in recovery. 

• Some patients temporarily or permanently use self-catheterization. 

Most patients gradually adapt to their new urinary routine. 

Living With a Neobladder 

Many people live full and active lives with a neobladder. 

Tips for Living with a Neobladder 

• Stay well hydrated. 

• Empty the neobladder regularly. 

• Follow your healthcare team’s monitoring schedule. 

• Watch for signs of urinary tract infections. 

• Discuss any continence concerns with your doctor. 

Many patients travel, exercise, work, and do normal daily activities after recovery.

Frequently Asked Questions About a Neobladder

What is a neobladder? 

A neobladder is a new bladder created from a section of the small intestine after the bladder is removed, most often because of bladder cancer. 

Can you urinate normally with a neobladder? 

Many patients can urinate through the urethra after recovery. Some may occasionally need to use a catheter to fully empty the neobladder. 

How long does a neobladder last? 

Many neobladders have functioned well for decades. Lifespan varies based on overall health, surgical outcomes, and ongoing medical care. 

Is a neobladder better than an ileal conduit? 

Neither option is universally better. The best urinary diversion depends on a patient’s health, cancer characteristics, lifestyle, and personal preferences. 

Can cancer develop in a neobladder? 

The risk is low, but cancer can develop in intestinal tissue used to create a neobladder. Regular follow-up care is important. 

Will I need to wake up at night to empty my neobladder? 

Some patients need nighttime urination, especially during the first months after surgery. This often improves as the neobladder adapts. 

Read Patient Stories About Living with a Neobladder

• Read Lionel’s Story: A Great Life with a Neobladder, 25 Years Later
• Rick’s Neobladder Story
• The New Normal: Listen to Real Stories of People Living with a Urinary Diversion