Bladder reconstruction (neobladder)

The surgeon makes the new bladder from a section of the bowel during the operation to remove the bladder.

They connect one end of the new bladder to the 2 tubes called ureters from the kidneys. They connect the other end to the tube that carries urine (pee) out of the body. This is called the urethra.

Urine drains from the kidneys into the new bladder.

With time and practice, most people learn to empty their new bladder in the same way as before the operation by passing urine into the toilet. Some people may need to pass a tube called a catheter into the urethra to empty their new bladder. This is called self-catheterisation.

Sometimes the surgeon may not be able to make the new bladder during surgery. If this happens, they make a urostomy instead. This means the surgeon makes a small opening called a stoma on the wall of the tummy (abdomen). 

After the operation urine drains out of the body from the stoma into a bag. Your surgeon will talk with you about the risk of this before surgery.

Getting used to a new bladder and learning to look after it takes time. Like anything new, it will get easier with time and practice. Your specialist nurse will give you lots of support before and after your operation. 

You may also find it helps to talk to others in a similar situation. Our Online Community has a bladder cancer forum where you can share your experience and find out how other people have coped.

To empty your new bladder, you tighten your tummy muscles by holding your breath and pushing down into your tummy. You need to do this regularly, because you do not have the nerves that tell you when your bladder is full.

At first, you will have to empty your bladder every 2 to 3 hours. The feeling of needing to pass urine (pee) can be different. You might find it helpful to set an alarm to remind yourself to pass urine. 

Over time, your new bladder will stretch and be able to hold more urine. But you may still have to empty it every 4 to 6 hours.

You may also need to pass a catheter into your urethra a few times. This is called intermittent self-catheterisation. It helps to make sure the new bladder is completely empty. If you need to do this, your specialist nurse will show you how.

To start with, you might leak urine, especially at night. But this usually gets better after a few months. Your specialist nurse or surgeon can suggest things to help. They may refer you to a continence adviser. 

Before your surgery, your nurse will show you how to do pelvic floor exercises. It is important to keep doing these as they can help you have more control over leaking urine.

You may feel anxious about going out in public and worry about finding a toilet in time. Planning ahead so that you are prepared can help you feel more confident. We have more information about using public toilets.

As well as emptying your new bladder regularly, you may have to wash it out. The bowel tissue used to make the new bladder continues to make mucus. This can cause an infection if it is not washed out. 

To do this, you put fluid through a catheter that is put into the new bladder through the urethra. Your nurse will show you how to do this.