This method of collecting urine creates a pouch that works the same way as the bladder. This pouch is called a neobladder, and it allows you to urinate as usual. Having a neobladder means you won’t need 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 portion 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.
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.
The neobladder may produce a thick white substance (mucus), which might appear as pale threads in the urine. The amount of mucus will lessen over time, but it won’t disappear completely.
Discuss any concerns with your nurse, physiotherapist, GP or urologist, and arrange follow-up visits with them.
See a continence nurse or a pelvic floor physiotherapist
They 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. During that time the neobladder may leak when full, and you may have to get up during the night to go to the toilet.
Strengthening the pelvic floor muscles before and after surgery will help you control the neobladder. A physiotherapist can teach you exercises.
It can sometimes 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 it should usually be done twice a day to reduce the risk of urinary tract infections.
I couldn’t control the number of urinary tract infections after my surgery, but once I started catheterising, it limited the infections.Mark
Ask about the Continence Aids Payment Scheme (CAPS)
This scheme is operated by Services Australia (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 to speak to a nurse continence specialist or visit The Continence Foundation of Australia.
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Prof Dickon Hayne, Professor of Urology, UWA Medical School, The University of Western Australia, Chair of the Bladder, Urothelial and Penile Cancer Subcommittee, ANZUP Cancer Trials Group, and Head of Urology, South Metropolitan Health Service, WA; A/Prof Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; Helen Anderson, Genitourinary Cancer Nurse Navigator (CNS), Gold Coast University Hospital, QLD; BEAT Bladder Cancer Australia; Mark Jenkin, Consumer; Dr Ganessan Kichenadasse, Lead, SA Cancer Clinical Network, Commission of Excellence and Innovation in Health, and Medical Oncologist, Flinders Centre for Innovation in Cancer, SA; A/Prof James Lynam, Medical Oncology Staff Specialist, Calvary Mater Newcastle, NSW; Jack McDonald, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Tara Redemski, Senior Physiotherapist – Cancer and Blood Disorders, Gold Coast University Hospital, QLD; Prof Shomik Sengupta, Consultant Urologist, Eastern Health and Professor of Surgery, Eastern Health Clinical School, Monash University, VIC.
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