The neo-bladder is drained with a catheter after surgery, one through the urethra. It will take some time for the new bladder to work, but ultimately works quite well during the day, but at night because the brain is not connected to the neobladder like it was with the native bladder leaks in about 50% of patients.
Patients may be incontinent during the day or night. During bladder removal, we remove the internal sphincter at the bladder neck and leave behind the external sphincter, which prevents the urine from leaking. This sphincter and the pelvic floor have to be strengthened before and after surgery with Kegel exercises. In addition, it takes time for the neobladder to stretch to the full capacity potential. If incontinence persists, physical therapy and artificial sphincters are also available. Sometimes the leakage can mean that the bladder is not fully emptying. Approximately 10% of patients (and more women than men) need to catheterize to keep their bladder emptying completely.