If the bladder is removed in a radical cystectomy, you will need a new way of collecting urine. Most people will have a stoma, but some may be offered a neobladder. This method creates a pouch that works the same way as the bladder. It allows you to urinate as usual without the need for a stoma.
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The procedure for creating a neobladder is more complex and takes longer than creating a urostomy. The neobladder is made from a short length of your small bowel that is shaped into a pouch and placed in the same area as your original bladder. The surgeon will stitch your ureters into the top area of the neobladder (chimney). Urine will drain from the kidneys through the ureters into the neobladder.
Strengthening the pelvic floor muscles before and after surgery will help you control the neobladder. A physiotherapist can teach you exercises.
It takes time to get used to a new bladder. The neobladder will not have the nerves that tell you when your bladder is full, and you will have to learn new ways to empty it. Discuss any concerns with your nurse, physiotherapist, GP and urologist, and arrange follow-up visits with them.
See a continence nurse
This specialist nurse will work with you to develop a toilet schedule to train your new bladder. At first, the new bladder won’t be able to hold as much urine and you will probably need to empty your bladder every 2–3 hours. This will gradually increase to 4–6 hours, but it may take several months. This may mean that the neobladder leaks when full, and you may have to get up during the night to go to the toilet.
It can often be difficult to fully empty the neobladder using your pelvic floor muscles, so the nurse will also teach you how to drain the bladder with a catheter. This is called intermittent self catheterisation and should usually be done twice a day to reduce the risk of infection.
Ask about the Continence Aids Payment Scheme (CAPS)
This scheme is operated by the Department of Human Services (Medicare) and provides a payment for eligible people needing a long-term supply of continence aids, including catheters for draining the bladder. You can ask the continence nurse if you’re eligible. Find out more at humanservices.gov.au or call the CAPS Team on 1800 239 309.
Contact the National Continence Helpline
Call 1800 33 00 66 or email email@example.com for more information.
Prof Dickon Hayne, UWA Medical School, The University of Western Australia, and Head, Urology, South Metropolitan Health Service, WA; BEAT Bladder Cancer Australia; Dr Anne Capp, Senior Staff Specialist, Radiation Oncology, Calvary Mater Newcastle, NSW; Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC; Dr Peter Heathcote, Senior Urologist, Princess Alexandra Hospital, and Adjunct Professor, Australian Prostate Cancer Research Centre, QLD; Melissa Le Mesurier, Consumer; Dr James Lynam, Medical Oncologist Staff Specialist, Calvary Mater Newcastle and The University of Newcastle, NSW; John McDonald, Consumer; Michael Twycross, Consumer; Rosemary Watson, 13 11 20 Consultant, Cancer Council Victoria.
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