✦ Urinary Diversion Treatment

Orthotopic Neobladder (Studer / W-Pouch)

Q: Will I need to self-catheterise after neobladder surgery?

About 15–25% of patients develop incomplete emptying and require intermittent self-catheterisation; most achieve complete emptying with time and pelvic floor exercises.

Q: When will I be continent after neobladder?

Daytime continence develops over 3–6 months as the pouch capacity increases; nocturnal continence may take 6–12 months to fully develop.

Q: Is neobladder suitable for women?

Yes, neobladder is performed in women in selected centres; urethral involvement by tumour must be excluded; continence outcomes are comparable to men.

Internal Urinary Reservoir — Voiding Without a Stoma Bag

4–6 Hours PROCEDURE

8–14 Days HOSPITAL STAY

>85% continence SUCCESS RATE

6–12 Weeks RECOVERY

What is Orthotopic Neobladder (Studer / W-Pouch)?

The Orthotopic Neobladder (Studer or W-Pouch) is a continent internal urinary reservoir constructed from a segment of detubularised ileum and anastomosed directly to the urethra, allowing the patient to void by relaxing the pelvic floor and using abdominal pressure — without a stoma. It provides the most natural voiding pattern of all urinary diversions, preserving body image and quality of life. After radical cystectomy, a 60–65 cm ileal segment is opened, folded into a U or W configuration, and anastomosed to both the ureters and urethral stump. Careful patient selection, intact urethral sphincter, and ability to self-catheterise if incomplete emptying occurs are essential prerequisites. The procedure is performed under general or spinal anaesthesia with a hospital stay of 8–14 Days.

Patients undergoing radical cystectomy with intact urethral sphincter, negative urethral margins, sufficient renal function (eGFR >40 mL/min), and the motivation and dexterity to manage possible incomplete emptying. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Reservoir Construction

40–65 cm ileal segment isolated; segment detubularised by opening along the antimesenteric border; U- or W-shaped pouch constructed by folding and suturing adjacent edges.

Ureteric Anastomosis

Ureters reimplanted into the proximal pouch or afferent isoperistaltic limb with anti-reflux or direct anastomosis.

Urethral Anastomosis

The dependent portion of the neobladder is brought to the membranous urethral stump and anastomosed with absorbable sutures.

Catheter Placement

Urethral catheter left for 3 weeks; pouch drained via catheter; pouchogram confirms integrity before catheter removal.

Pelvic Floor Rehabilitation

Pelvic floor exercises begin post-operatively; daytime continence develops over 3–6 months; nocturnal continence over 6–12 months.

Outcomes

4–6 HoursDURATION

8–14 DaysHOSPITAL STAY

>85% continenceSUCCESS RATE

6–12 WeeksFULL RECOVERY

Who Needs This Treatment?

→No stoma — patient voids naturally through the urethra without any external appliance.
→Best quality of life and body image of all urinary diversion options.
→Day continence >85%; nocturnal continence may take 6–12 months to fully develop.
→Eliminates urostomy bag and all stomal complications.
→Oncologically equivalent to ileal conduit after cystectomy.
→Patients report highest satisfaction among all diversion options.

"The neobladder is the closest we can come to restoring normal anatomy after cystectomy. When the right patient achieves full continence through their own urethra, the transformation in their quality of life is remarkable."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Will I need to self-catheterise after neobladder surgery?+

When will I be continent after neobladder?+

Is neobladder suitable for women?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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