Reconstructive Surgery
Neurogenic bladder is a condition where the nerves that control the bladder are damaged, leading to a loss of bladder control. This nerve damage can be caused by a variety of issues, including neurological diseases, spinal cord injuries, or conditions like diabetes. In these cases, bladder reconstruction may be needed.
What is Reconstructive Surgery
These major reconstructive surgeries are reserved for the most severe cases where standard therapies have failed. It is a significant commitment to undergo these procedures due to the potential complications and need for lifelong management.
There are two reconstructive treatment options often offered to patients with severe, treatment-resistant OAB. Both are complex options which require careful consideration and conversation with your surgeon.
Augmentation Cystoplasty
This procedure enlarges the bladder by using tissue from the patient’s intestine. The goal is to increase the bladder size and capacity so it can store more urine.
Augmentation cystoplasty is considered only if the patient is willing to use a catheter to empty their bladder for the rest of their life, as it can be difficult to urinate normally after surgery. Augmentation cystoplasty carries a risk of complications, including recurrent UTIs.
Neobladder Reconstruction
During this reconstructive procedure for OAB, the patient’s original bladder is removed (a cystectomy), and a new bladder (neobladder) is created from a segment of the small intestine. This new bladder is placed in the same location as the original bladder. The goal is to create a new, functional bladder that can store and release urine voluntarily.
Neobladder reconstruction is a complex procedure for patients with non-functioning or diseased bladders. Following surgery, patients can urinate voluntarily, but it may require the use of a catheter, which they can insert and remove as needed.
