WHAT IS AN ORTHOTOPIC NEOBLADDER?
Is It Possible to Urinate Normally After Bladder Removal?
Assoc. Prof. Dr. Serdar Yalçın
Urology Specialist
QUICK SUMMARY
An orthotopic neobladder is an advanced form of urinary diversion that may be offered to carefully selected patients following radical cystectomy. During the procedure, a segment of the small intestine is reconstructed into a new urine reservoir and connected to the urethra, allowing many patients to urinate through the natural urinary passage. According to the 2026 European Association of Urology (EAU) Guidelines, an orthotopic neobladder is an excellent reconstructive option for appropriately selected patients and may provide excellent functional outcomes and quality of life.
TABLE OF CONTENTS
What is an orthotopic neobladder?
Who is a candidate for a neobladder?
How is a new bladder created?
Can patients urinate normally?
What are the advantages?
Are there any disadvantages?
What is life like after surgery?
The EAU 2026 key message for patients
Neobladder reconstruction with Assoc. Prof. Dr. Serdar Yalçın
Frequently Asked Questions
WHAT IS AN ORTHOTOPIC NEOBLADDER?
An orthotopic neobladder is a surgically created urinary reservoir constructed from a segment of the small intestine after the urinary bladder has been removed.
The newly created bladder is connected directly to the urethra.
This allows appropriately selected patients to empty urine through the natural urinary passage.
Although it functions similarly to the native bladder, a neobladder is not identical to the original bladder and requires a period of adaptation and rehabilitation.
WHO IS A CANDIDATE FOR A NEOBLADDER?
An orthotopic neobladder is not suitable for every patient.
It may be considered in carefully selected patients who have:
• A preserved and cancer-free urethra
• Good kidney function
• No significant bowel disease
• The ability to participate in long-term follow-up
• The motivation and physical ability to complete postoperative rehabilitation
The decision should always be individualized after comprehensive evaluation.
HOW IS A NEW BLADDER CREATED?
During surgery, a segment of the small intestine is reshaped into a spherical urine reservoir.
Both ureters are connected to this new reservoir.
The reservoir is then attached to the urethra.
The objective is to restore urinary storage and allow urination through the natural urinary channel whenever possible.
CAN PATIENTS URINATE NORMALLY?
Yes.
Many patients are able to urinate through the urethra after recovery.
However, learning how to empty the new bladder takes time.
Some patients experience nighttime urinary leakage during the adaptation period, and a small number may require intermittent self-catheterization if complete bladder emptying cannot be achieved.
WHAT IS LIFE LIKE AFTER SURGERY?
During the first several months, the neobladder gradually increases its capacity.
Patients learn scheduled voiding techniques and pelvic floor muscle training.
Appropriate hydration, regular follow-up, and structured rehabilitation are essential for achieving optimal long-term functional outcomes.
THE EAU 2026 KEY MESSAGE FOR PATIENTS
According to the 2026 European Association of Urology (EAU) Guidelines, an orthotopic neobladder should only be offered to carefully selected patients.
The decision should consider:
• Oncological safety
• Kidney function
• Urethral suitability
• Patient expectations
• Lifestyle
• Ability to participate in long-term follow-up
NEOBLADDER RECONSTRUCTION WITH ASSOC. PROF. DR. SERDAR YALÇIN
Assoc. Prof. Dr. Serdar Yalçın carefully evaluates every patient undergoing radical cystectomy in Bodrum, Türkiye, to determine whether an orthotopic neobladder is an appropriate option according to the latest European Association of Urology (EAU) Guidelines.
Urinary diversion options—including ileal conduit, orthotopic neobladder, and other reconstructive procedures—are discussed in detail, taking into account cancer characteristics, kidney function, lifestyle, personal expectations, and long-term quality of life.
In addition to patients from Bodrum and the Muğla region, individuals from across Türkiye and abroad seek consultation for second opinions, robotic bladder cancer surgery, and reconstructive