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Neobladder surgery options
Hmm, where to begin.
A little background. I've had cancer twice in the past at 17months - 4 years old, then re-occurred from 5-7 years old with Rhabdomyosarcoma. Fast forward to May 2026 and I was diagnosed now at 45 with SCBC. So this is my third time. Anyway, initial pet scan is showing localized and contained to the bladder. We just finished 4 rounds of cisplatin/etoposide. Currently, waiting 3 weeks for the next pet scan.
Alright, so I've spoken with my surgeon and he mentioned 3 different types of surgeries for neobladder. I'm curious which is best or if it's just a preference? I was pretty much going for whatever would keep some nerve endings for sexual feeling, while still providing best chance at survival. But then robots, semi robot, open up came up in discussion and I was just like um, I pick the survival one. Which one is that? Any input from others would be appreciated as to which you chose and why.
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Hello @deedubs1980 and welcome to Mayo Connect. You have a good record of beating cancer in your lifetime. So sorry that you had to have that battle at all. My husband had a neobladder surgery at Mayo Clinic in 2021. he was only offered open surgery likely because he had a previous partial cystectomy to remove the original tumor, and 29 lymph nodes removed at that time. That leaves a lot of scar tissue to deal with. Nerve sparing was never discussed. With his many complications postop and over the next 2 years, he has had a couple other surgeries done robotically. A large incisional hernia repair placing mesh across his abdomen was done robotically and the recovery was amazingly quick and less painful. If your surgeon feels that a robotic or even semi gives the same survival odds as open, then I would suggest that route for a faster recovery and less discomfort. Where are you receiving your medical care, if you don't mind sharing?
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4 Reactions@deedubs1980,, you may also be interested in these related discussions:
- Neobladder experiences https://connect.mayoclinic.org/search/discussions/
During the neobladder reconstruction, a surgeon uses a piece of intestine to create a new bladder. The new bladder allows a person to urinate voluntarily and control when to urinate. The procedure is also called an orthotopic neobladder reconstruction. Orthotopic refers to things being in their usual place in the body. The new bladder is placed in the same location as the original bladder.
It sounds like your surgeon was giving you the option between robotic-assisted surgery or open surgery. Were you able to discuss the pros and cons of each for you? Which surgical option did you choose?
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Thanks for the input. I kind of told him what gives him the best chance of getting everything. It sounded like he open was the best for my situation. But I think it was going to be open and semi robotic. I'm at Mayo Clinic AZ.
@colleenyoung
When we were talking he said a lot of women prefer the robotic one as it makes 4 incisions and then it's a smaller opening. I was concerned about the doctor having space to perform what he needs to do. He mentioned a lot of women prefer that as they can still wear a 2 piece. I mentioned I don't care about the scare in a banana hammock. But all joking aside, want what he thinks is the best chance of survival and that he can get everything. I'd rather have this done once then having to deal with issues or problems after. Don't think we talked much about pros and cons vs more of survival since it's such an aggressive cancer. I pretty much told him I was ok with the open since he thought he could spare the nerves on the right side. Said left side he doesn't think so.
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