Bladder ReconstructionBladder reconstruction is necessary for patients who have their bladder removed to treat bladder cancer or another condition.
When a patient undergoes bladder removal surgery (radical cystectomy), the surgeon must also complete urinary diversion surgery. There are several types of procedures, all of which involve a part of the intestine being surgically converted. The goal of these procedures can be either to create a passage tube for urine to exit the body or to create a new reservoir for the body to store urine.
Types of Bladder ReconstructionThere are three options for bladder reconstruction surgery:
Incontinent Urinary DiversionIn this procedure, the surgeon uses part of the patient’s small intestine to create a passageway connecting the ureters, which carry urine from the kidneys to an opening created in the abdomen called a stoma. Urine then empties into a pouch outside the body.
Continent Cutaneous Urinary DiversionThe surgeon uses a portion of the patient’s stomach or intestine to create an internal reservoir for urine that the patient can periodically empty by inserting a tube into a stoma that was created during surgery.
Bladder Substitute (Neobladder)This option involves actual bladder reconstruction and may be possible if the patient’s urethra is not removed during surgery. A small piece of the patient’s intestine is used to create a sac to hold urine, and the sac is attached directly to the ureters and urethra. This allows the patient to pass urine the same way he or she did before surgery.
What to Expect
There are benefits and drawbacks to each type of bladder reconstruction:
- Incontinent urinary diversion – This is a relatively simple procedure, though the use of an external bag for urine collection is not ideal for many patients.
- Continent cutaneous urinary diversion – No external bag is needed and the chance of urine leakage is minimal. However, the patient must empty the internal reservoir every four hours, around the clock.
- Bladder substitute – This process most closely matches normal urination and no stoma or external bag is needed. Potential disadvantages include urinary incontinence and the possible need for occasional catheterization.
No matter what type of bladder reconstruction surgery a patient has, it may take a month or two for him or her to recover and regain their strength.
How Effective Is Bladder Reconstruction?
Individuals who undergo bladder reconstruction are usually able to return to the life they previously enjoyed with few restrictions (if any) on work, activities, diet and travel.
At Tampa General Hospital, our urology team provides both surgical and nonsurgical specialty treatments for urology problems in a single, convenient location. We work hand-in-hand with each individual we treat to help them make the best and most informed decisions about their urological health care.