What is involved in self catheterization with a neobladder?

I've had a neobladder (I'm female) since last early November and haven't had any problems or infections. (Fingers crossed). One thing my surgeon explained was that you don't want to go too long without using the bathroom with a neobladder. If it stretches too much, you are more likely to have difficulty emptying well and have to catheter. I routinely set my alarm at night to get up every few hours. He suggested not going past 4-5 hours. To be safe, I wake up every 3 hours to void. Just sharing in case it helps! I love my new bladder. So thankful I was able to go this route. Good luck!!

Measuring urine recovered via catheter after attempted neobladder emptying by voiding is what the Urology staff at Mayo did for my husband. They are pretty satisfied with less than 100ml residual after voiding. But my husband now has kidney damage from backup of urine when ureter blocked so he needs to avoid a full neobladder. He caths usually 4 times a day. It has gotten very quick and easy with time.

Following is my experience and hope it gives you some guidance. My catheter was removed three weeks after removal of my bladder. For about four weeks or so it seemed like I my neobladder was emptying. I started having severe pain in my lower back and went to the emergency room. It was determined that my bladder was not emptying and was backing up in my kidneys. I had to start doing self catherization. I have been doing so for four years without problems. Bottom line is I know of no way without medical tests that you can determine if your neobladder is emptying without self catherization. If you have to self catherize, my experience is it is it is no big deal. I do so about every four hours or six times per day. It is not painful.

I was told you always have urine left in your bladder (neo and regular) but I kept getting infections and I would have to urinate again shortly after all ready urinating. So the drs checked my bladder and I was not emptying enough. Less than 100 is pretty good. So they had me cathing 4x a day as needed. Now infections are less . So must be doing something right.

Can you @moose63 @sepdvm @moose63 @lennypo18, share: How would a person know his/her neobladder doesn’t fully empty before doing self catheterization? Is a complete voiding (i.e., zero residual urine in the bladder) possible for a regular bladder or neobladder? Do urologists think it is normal and okay if residual urine is less than 100cc in a bladder after voiding? Appreciated!

I have had a neo bladder for 6 years. I cath when needed. It works great! I am female at times if there is a lot of mucus it leaks. I just wear a pad. It’s a change of life I would rather have that then the other options. I can urinate on my own if I don’t have a cath. The only thing is it doesn’t fully empty. But I can cath later to empty I can say for me it was the right choice.

No way to know if you will need to use a catheter until after surgery. My understanding is most people do need to use a catheter. I find using a catheter is no problem. I travel a lot and have been able to manage the process where ever I am. Hope and pray your surgery goes well and without complications.

I’ll be having bladder removed after chemo. Will your husband have to self catheterize himself daily forever, or is this temporary? I’m still trying to decide between ileal conduit or neobladder. I’m a male age 47.

Glad that postoperative challenges have subsided. I sure agree that having to use a catheter is much better than an ostomy or cancer! God bless.

Hello @jimelee108
My husband had lots of postop issues with his neobladder but things have settled down now. He needs to catheterize 3-4 times daily as normal urination just does not empty the neobladder. He has had strictures at the urethral neobladder junction so they need him to use a larger diameter catheter to keep this open. Despite this, he finds catheterization nonpainful, nothing like the cystoscopies I am sure you have experienced. He also prefers the prelubricated catheters for ease of use and gets a script from his urologist to keep a nice supply on hand. He did try different catheters as some pass more easily than others and the urology department has been great about making recommendations. The prelubed ones have won him over. Lots of hand washing before to prevent infection, sterile gloves can be used as well. While it is a big change, for him it is better than an ostomy and much better than cancer.