Neobladder Surgery - The Importance of Kegel Exercise
Neobladder is a form of bladder reconstruction surgery, often used in patients who have had cancer, or have needed their bladder removed (cystectomy) for another reason. Neobladder is major surgery, and in order to maintain continence after the procedure, it is vitally important to Kegel exercise to strengthen the pelvic floor and maintain control and continence.
What is Neobladder Surgery?
Sometimes if people suffer from bladder problems, the bladder is removed in a procedure called a Cystectomy, which takes away the bladder but leaves behind some of the urethra - the small tube that urine passes through. A new bladder or 'neobladder' is then made out of a small section of the bowel and attached to the urethra and ureters (the tubes that drain urine from the kidneys).
During surgery, the surgeons try their best to leave as many of the nerves in place as possible so that you can be as continent as possible, and the bladder can often be emptied in the normal way.
What Does Neobladder Surgery Involve?
You will be admitted into hospital for your surgery and you will have a general anaesthetic (you will be put to sleep). The length of your operation depends on how complicated it is - a straightforward operation might last around 2-3 hours, but a more complicated one may take over 5 hours.
After the operation, you will probably feel some pain, but the nurses and doctors will make sure that you are given enough painkillers so that you do not need to suffer.
You will also have a catheter inserted into your bladder to make sure that it is kept completely empty so can heal properly.
Neobladder surgery is major surgery, so your nurses and consultants will discuss with you what to expect both before, during and after surgery. If you have any concerns, no matter if you think they're small and insignificant, don't be afraid or embarrassed to ask.
Can I Eat and Drink After Neobladder Surgery?
Once your doctor gives the all clear, you will be able to start drinking small sips of water, but won't be able to drink properly until your bowel is working again. This may be a few days. Once you can drink, you will be able to start eating small snacks such as soup and toast, which you can then slowly and gradually build up to a normal diet.
Will I Suffer Incontinence After Neobladder Surgery?
For around the first 3-4 weeks, you will have a catheter in place to drain your bladder to help it to heal properly. Once you have had the catheter removed, you will find:
- For the first 1-2 weeks, you will need to empty your bladder every 2 hours in the day, every 3 hours at night (so you will need to set an alarm)
- In the 3rd week, you will need to empty your bladder every 4 hours in the day and every 5 hours at night.
- By the 4th and 5th week, you should only need to empty your bladder every 5-6 hours during the day and night.
By week 6, your neobladder will have stretched to be able to hold around a pint of urine (which is the same as a normal bladder).
Neobladder Surgery Recovery
The best way to combat incontinence after neobladder surgery is to strengthen your pelvic floor before and after your operation.
Before your operation, you can use one of our market-leading Kegel8 Ultra 20 pelvic exercise devices to strengthen your pelvic floor and get your muscles in peak condition ready for your surgery.
After your operation, you should not carry out pelvic floor exercises (even manual Kegels) until your consultant says that it's safe to do so - neobladder surgery is major surgery and you need to give your body a chance to heal.
Once you've got the go-ahead, it's great to start with manual Kegel exercises to begin your pelvic floor's recovery process. It's important to do 'fast' Kegels and 'slow' Kegels to work both the fast and slow twitch muscle fibres in your pelvic floor. (Read about how to do the most effective manual Kegels to work both types of muscle fibres in our article here).
The slow twitch muscle fibres are the ones that work constantly to help you to retain urine and support your pelvic muscles. The fast twitch muscle fibres act almost like a 'tap' - they react quickly when you sneeze and cough, and they also work to shut off the flow of urine and help to prevent accidents - so after neobladder surgery it's very important to work both types of muscles to give yourself the best chance of recovery.
Don't forget, Kegel exercises work for both men and women!
Further down the line after your surgery, it is worth asking your surgeon when you can restart using your Kegel8 device.
Please note - If your neobladder surgery is due to some form of pelvic cancer, use of the Kegel8 Electronic Pelvic Toner is contra indicated whilst cancer cells are still present, please refer to your healthcare provider, physiotherapist or Consultant.