Robotic Neobladder
A robotic neobladder is a type of urinary diversion performed after bladder removal (radical cystectomy) where surgeons use the robotic approach to create a new bladder (neobladder) from a segment of the patient’s intestine. This allows urine to pass through the urethra in a way that closely mimics natural urination.
What It Is
- After the bladder is removed (due to bladder cancer or other severe disease), the surgeon uses a section of the ileum (small intestine) to construct a spherical “new bladder.”
- Using robotic surgery, the neobladder is shaped inside the body (intracorporeal) and attached to the ureters (bringing urine from kidneys) and the urethra (to allow voiding).
Advantages of Robotic Neobladder
- Minimally invasive: Smaller incisions, less blood loss, quicker recovery vs open surgery.
- Natural voiding: Patient can pass urine through the urethra instead of needing a stoma bag.
- Cosmetic benefit: No external bag (compared to ileal conduit).
- Quality of life: Many patients prefer it because it feels more natural.
Recovery & Lifestyle
- Hospital stay: ~7–12 days.
- Catheter: Usually required for 2–3 weeks while the neobladder heals.
- Training period: Patients must learn how to contract abdominal muscles and relax pelvic muscles to void.
- Continence outcomes:
- Daytime continence: achieved in ~80–90% of patients after 6–12 months.
- Nighttime continence: usually lower (~70%).
Who Is a Candidate?
- Patients with good kidney function.
- No urethral cancer involvement.
- Motivated, younger or healthier patients who can handle the training.
- Not ideal for very frail patients or those with poor bowel/kidney function.
A robotic neobladder is the most advanced urinary diversion option after robotic cystectomy. It restores near-normal urination, but requires patient motivation, rehabilitation, and close follow-up.