What is a Neobladder? What Patients with Bladder Cancer Need to Know

For patients with bladder cancer undergoing radical cystectomy, or the surgical removal of the bladder, one possible option is to then receive a neobladder. Under this procedure, a new bladder is created from a section of the small intestine.

“I generally like to do [bladder removal surgeries as] laparoscopic robot assisted,” said Dr. Janet Kukreja in an interview with CURE. “So what that means is we make little incisions in the abdominal wall, and we put ports through them, and then we put the instruments through the ports and dock the robot to those. But, what it allows me to do is it allows me to get really deep into the pelvis and be able to see everything. When you do the surgeries open, it's very hard to get both hands in the pelvis, and do a very fine surgery, at least for me anyway. So we do the bladder removal, often we remove lymph nodes with it as well to make sure that the cancer hasn't spread to the lymph nodes. And then we make some sort of urinary diversion, some way to reroute the urine to leave the body.”

Among Kukreja’s patients is Deion Sanders, the football star and coach at the University of Colorado. Sanders, 57, made news this month when he announced that had received a diagnosis of bladder cancer, but his care team considered him cured after the surgical removal of his bladder.

Sanders, Kukreja explained, then received a neobladder. Speaking with CURE, she detailed what a neobladder is and how it functions for patients.

Kukreja is the director of urologic oncology at the CU Cancer Center and UCHealth University of Colorado Hospital.

Transcript

What we do is we use small intestine, and we form it into a ball, and then we hook it to the urethra, and inside we sew it to the urethra, and then we hook the kidneys up as well on the inside, so that the urine drains down into it and it becomes a new reservoir. It's different than native bladders. It doesn't have a muscle on it. So, your native bladder has a muscle that does this. Neobladders don't have a muscle, but they serve as a very low-pressure reservoir which is good for your kidneys to drain into. And so people empty it by pushing their abdominal muscles down, as if they're really constipated or have to think of it as a balloon in the pelvis that they have to deflate with their abdominal muscles, and to push the urine out they do that.

Transcript has been edited for clarity and conciseness

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