Bladder reconstruction (neobladder)

Bladder reconstruction is surgery to make a new bladder if your bladder has been removed.

What is bladder reconstruction (neobladder)?

Bladder reconstruction surgery is an operation to make a new bladder if your bladder has been removed. This is called a neobladder.

Surgery to remove the bladder is called a cystectomy. You may have this as part of your treatment for bladder cancer.

Bladder reconstruction is one type of urinary diversion surgery. There are different urinary diversion options. We have more information about the following types:

  • Urostomy  – this is also called ileal conduit urinary diversion or sometimes incontinent urinary diversion.
  • Continent urinary diversion – this is sometimes also called a mitronoff urinary diversion.

How a neobladder is made

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.

A bladder reconstruction (neobladder)
Image: A bladder reconstruction (neobladder)

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.

After surgery

After your surgery, you may have a tube that goes through the tummy wall into the new bladder. This drains urine (pee) and will help if there are any problems where the new bladder joins the urethra. Your nurse will explain when this can be removed.

You will also have a tube called a catheter in the urethra to drain the urine from your new bladder. This stays in place for a few weeks while you recover from the operation. Your nurse will explain how to look after the catheter and your new bladder before you go home.

The bowel tissue used to make the new bladder continues to make mucus. This is a thick, white liquid. It might appear as pale threads in the urine. To stop this blocking the catheter, you need to flush the catheter several times every day using fluid and a syringe. Your nurse will show you how to do this, or they may arrange for a district nurse to help.

Before you leave the hospital, the nurse will make sure you have a supply of the equipment you need.

Having your catheter removed

A few weeks after surgery, you will return to the hospital. Some people may have an x-ray called a cystogram to check how the new bladder is working. If there are no signs of leaks or other problems, your nurse or doctor will remove the catheter.

You may have to stay in hospital for 1 or 2 days after this. This is to make sure your bladder is emptying fully.

Living with a neobladder

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.

Emptying your new bladder

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.

Leaking urine

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.

Looking after your new bladder

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.

About our information

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 01 November 2022
Next review: 01 November 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

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