Pharmacy Services Charges including Drugs &Medical Consumables
1.Overstay more than package days, 2. Any other Specialty Consultations, 3. Special Equipment, 4. Additional Procedure/Surgery. 5. Blood Components.
What is Neobladder?
Neobladder reconstruction is a surgical procedure to construct a new bladder. After bladder removal surgery (cystectomy) for bladder cancer or another condition, your surgeon must create new way for urine to exit your body (urinary diversion). Neobladder reconstruction, also called orthotopic neobladder reconstruction, is one option for urinary diversion. During the procedure, your surgeon uses a piece of intestine to create a new bladder that allows you to urinate voluntarily and maintain continence.
Reasons of Neobladder
Some reasons that people have their bladders removed include:
Nonfunctional bladder caused by radiation therapy, neurologic conditions or chronic inflammatory disease
Urinary incontinence that hasn't responded to other treatment
Birth defects that cannot be repaired
Trauma to the bladder
Risks Involved in Neobladder
Vitamin B-12 deficiency
Cancer in the bowel
Let your doctor know about all of the medications, vitamins and dietary supplements. In some cases, you may need to stop these medications before your surgery.
You may also have an imaging test, such as a CT scan, of your urinary tract to check the ureters — tubes that carry urine from the kidneys to the bladder — to see that they are in good condition before surgery.
To create a neobladder, your surgeon first removes your cancerous bladder (cystectomy) through either a traditional abdominal incision or with a robot-assisted laparoscopic approach (robotic surgery). Your surgeon then reshapes a section of your small intestine, colon or a combination of the two into a sphere, which becomes the neobladder.Your surgeon places the neobladder in the same location inside your body as your original bladder. The neobladder is attached to your ureters so that urine can drain from your kidneys into the neobladder. The other end of the neobladder is attached to your urethra. This allows you to maintain urinary control with a functional bladder capable of storing urine without the need for external bags or appliances.
After the Procedure
The hospital stay after neobladder reconstruction is usually about three to five days. As with any bladder substitute, it may take some time until the neobladder functions best. Immediately after surgery, many people may have difficulties with urinary incontinence until the neobladder stretches to a normal size and the muscles that support it get stronger. Daytime continence usually improves over the first three to six months after surgery, though it may continue improving for up to 12 months. Nighttime continence may take slightly longer, and can keep improving into the second year. Lifelong follow-up is necessary after a neobladder reconstruction.
Immediately after surgery, many people may have difficulties with urinary incontinence until the neobladder stretches to a normal size and the muscles that support it get stronger. Daytime continence usually improves over the first three to six months after surgery, though it may continue improving for up to 12 months.
The neobladder is made from a short length of your small bowel, which is shaped into a pouch and placed in the same area as your original bladder. The surgeon will stitch your ureters into the top area of the neobladder (chimney). Urine will drain from the kidneys through the ureters into the neobladder.
Not everyone is a candidate for a neobladder reconstruction; for example, patients must have full kidney and liver function, and cannot have cancer in urethra. However, many patients prefer this type of diversion compared to an ileal conduit (external collecting bag that sticks to the abdominal wall).
It usually takes 4 to 8 hours to complete this operation. On completion of the operation the surgeon will contact your family there. A portion of your intestines will be used to create the urinary diversion.
If you've had your bladder removed, you'll need to get used to a new way to pass urine from your body. The operation you had, called a cystectomy, is a lifelong change. You may have to bathe differently and adjust your travel habits.
The newly constructed neobladder is small and thus more likely to leak urine. Over a few months, the neobladder with stretch in size, so eventually it will hold 400-600 ML of urine. When the neobladder eventually stretches to a large size, it becomes a low pressure reservoir, making urine control possible.
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