Reconstructive urology · UK specialist centres
Neobladder formation and reconstruction, by a UK reconstructive urologist.
An orthotopic neobladder rebuilt from your own bowel, at a high-volume UK cystectomy centre - with all three diversion options honestly on the table, and a named consultant from first message to follow-up.
Why patients choose us
- 01
A high-volume reconstructive urologist
Neobladder formation is complex reconstructive surgery. We route you to a named consultant at a high-volume UK centre - not a generalist.
- 02
All three diversions on the table
Ileal conduit, neobladder, continent cutaneous pouch. We help you understand which fits your anatomy, cancer stage, fitness and lifestyle - not the surgeon’s preference.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial. Cystectomy MDT decisions are life-changing - a second view costs you nothing.
Indicative pricing
What neobladder reconstruction costs in the UK.
Indicative ranges across our partner reconstructive urology centres. Send the details and we quote firm figures across two or three options. NHS funding is available at specialist cancer centres.
In short
A private radical cystectomy with neobladder in the UK: £30,000–£55,000, home in 10–14 days.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Radical cystectomy + neobladder (private) | £30,000–£55,000 | 6–10 hrs | 10–14 days inpatient |
| Radical cystectomy + ileal conduit (private) | £25,000–£45,000 | 5–7 hrs | 7–10 days inpatient |
| Radical cystectomy + Indiana pouch (private) | £30,000–£50,000 | 6–9 hrs | 10–14 days inpatient |
| Robotic-assisted radical cystectomy (uplift) | +£4,000–£8,000 | Adds 1–2 hrs | Same |
| Reconstructive urology consultation | £300–£500 | 45–60 min | Same visit |
| Cystoscopy + urethral biopsy (workup) | £1,200–£2,400 | 30 min | Same visit |
Prices vary by centre, by the reconstructive urologist, by open vs robotic approach, and by length of ITU/HDU stay. NHS-funded surgery at a specialist urological cancer centre is the standard route - private is chosen for surgeon choice, timing or non-cancer indications. We come back with a firm quote within one working day.
The problem
The right diversion, the right surgeon, the right centre.
Cystectomy plus reconstruction is a life-altering operation. Outcomes depend on volume, on honest patient selection, and on choosing between neobladder, ileal conduit and continent cutaneous pouch for the right reasons.
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Is a neobladder right for you?
Fitness, renal function, urethral disease and lifestyle all matter. Not every patient is a candidate - and pretending otherwise leads to regret.
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A high-volume centre, always
Complication rates fall sharply at centres that do this operation regularly. We route you to one - no exceptions.
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A second view on the MDT plan
A calm, independent conversation with a reconstructive urologist before you sign - including whether more staging is needed first.
The journey
From enquiry to continence training - what happens, in order.
One named consultant, one specialist centre, and one team from first message to twelve-month follow-up.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · Surgery and inpatient stay
Ten to fourteen days in hospital
Phase 3 · After
Concierge, back on
- 01
Before
You tell us where you are
A short, confidential form. Cystectomy planned or already discussed, stage, fitness, renal function, and what matters to you about recovery.
- 02
Before
We come back with a recommendation
Within one working day: a shortlist of reconstructive urologists at high-volume UK centres, indicative pricing, and whether a neobladder is realistic for you.
- 03
Before
Assessment and workup
Renal function, imaging staging, urethral biopsy if needed, anaesthetic review, stoma nurse counselling (in case plans change intra-operatively), and pre-habilitation.
- 04
Inpatient
Radical cystectomy + neobladder
A 6–10 hour operation. Bladder and pelvic nodes removed, 40–60 cm of ileum reconfigured into a spherical reservoir, ureters implanted, anastomosis to the urethra.
- 05
Inpatient
ITU or HDU overnight
Twenty-four to forty-eight hours in critical care for close monitoring. Epidural or PCA for pain, early mobilisation, ERAS pathway.
- 06
Inpatient
Ten to fourteen days in hospital
Bowel function returns, drains and lines come out gradually. You go home with a urethral catheter and a suprapubic catheter in place.
- 07
After
Catheter removal and continence training
At 3–4 weeks a cystogram confirms no leak. Catheters come out. Timed voiding begins - daytime continence over weeks, nocturnal continence over 6–12 months.
Typical end-to-end: 4–6 weeks from enquiry to surgery. Continence: daytime over weeks, nocturnal over 6–12 months.
When it helps
When a neobladder is the right diversion.
The situations where an orthotopic neobladder is considered - and the one absolute red flag that rules it out.
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Muscle-invasive bladder cancer
T2–T4a bladder cancer needing radical cystectomy. Neobladder is one of three reconstruction options considered at MDT.
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BCG-refractory high-risk NMIBC
High-grade non-muscle-invasive disease that has failed BCG - cystectomy is offered, and neobladder is an option for fit, motivated patients.
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Radiation cystitis
A small, painful, bleeding bladder scarred by prior pelvic radiotherapy. Cystectomy with diversion can be considered.
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Severe interstitial cystitis
End-stage, refractory BPS/IC with a contracted bladder and disabling symptoms - cystectomy with diversion is a last-resort option.
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Contracted or neurogenic bladder
A small-capacity bladder from schistosomiasis, chronic BCG scarring, or severe neurogenic disease may be managed with cystectomy and reconstruction.
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Congenital bladder anomaly
Adults with congenital anomalies who have exhausted other options may be offered cystectomy and orthotopic diversion.
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Fit, motivated, wants to void per urethra
Neobladder is chosen - not defaulted to. It suits patients who value voiding naturally and accept the trade-offs (nocturia, possible CIC).
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Red flag: urethral tumour
Cancer at the urethral margin is an absolute contraindication to a neobladder. An ileal conduit or continent cutaneous diversion is used instead.
Diversion options
A neobladder is not the only diversion.
The three families of urinary diversion - orthotopic neobladder, ileal conduit and continent cutaneous pouch - and the neobladder variants used at UK centres.
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Studer neobladder
The most common UK neobladder. Detubularised ileum with an isoperistaltic afferent limb for the ureters. Reliable, well-studied, good long-term outcomes.
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Hautmann W-pouch
Detubularised ileum reconfigured as a W-shape. Large capacity, low pressure - a workhorse alternative to the Studer.
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VIP (Vesica Ileale Padovana)
An Italian variant of the ileal neobladder. Used by some UK reconstructive centres; outcomes comparable to Studer and Hautmann.
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T-pouch
A neobladder with an antireflux mechanism at the ureteric implantation. Aims to protect the upper tracts long-term.
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Ileocolic neobladder
Uses colon rather than ileum. Better nocturnal continence in some series, but more electrolyte and metabolic issues - used less often.
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Ileal conduit (Bricker)
The alternative if a neobladder is not right. A short segment of ileum brings urine to a stoma on the abdominal wall. Simpler, robust, suits older or frailer patients.
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Indiana pouch (continent cutaneous)
A continent internal reservoir emptied by clean intermittent catheterisation through a small abdominal stoma. See our Mitrofanoff page.
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MDT-only consultation
Sometimes the answer is not surgery yet - chemoradiotherapy, more staging, or a second opinion. We arrange that too.
Our vetted UK network
A small panel of reconstructive urologists, at high-volume centres.
Named consultants at specialist urological cancer centres - Queen Elizabeth Birmingham, UCLH, Guy’s, Southampton, Manchester, Leeds. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every reconstructive urologist in our network.
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Reconstructive urologists at high-volume UK cystectomy centres
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Full MDT review - oncology, radiology, stoma nursing, anaesthetics
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All diversion options offered - neobladder, ileal conduit, continent cutaneous
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ERAS pathway, robotic cystectomy where appropriate, stoma-nurse pre-counselling
Safety and long-term life with a neobladder
What to expect - honestly.
Radical cystectomy with neobladder is major surgery with lifelong follow-up. Daytime continence is very good, nocturnal continence is imperfect, and metabolic monitoring matters for the rest of your life.
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Major reconstructive surgery
Cystectomy with neobladder is a 6–10 hour operation with an ITU/HDU stay and 10–14 days in hospital. Recovery to normal activity takes 2–3 months.
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Daytime continence is very good
Around 90% of patients are continent by day within 12 months. Pelvic-floor physiotherapy after catheter removal helps meaningfully.
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Nocturnal continence takes time
60–80% are dry at night by 12 months. Most patients wake once or twice to void - the neobladder does not signal fullness the way a native bladder does.
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Some patients need intermittent catheterisation
Around 10–30% cannot empty the neobladder fully and need clean intermittent self-catheterisation (CIC) - either occasionally or daily.
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Metabolic changes are routine
Bowel in contact with urine causes a mild hyperchloraemic metabolic acidosis. Oral bicarbonate keeps this in check. Annual B12 checks matter after terminal-ileum resection.
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Erectile function often changes
Nerve-sparing cystectomy preserves erections in many men. Without nerve-sparing, erectile dysfunction is nearly universal - this is discussed in detail before surgery.
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Mucus, stones, UTIs are ongoing
The neobladder produces mucus (occasional pouch washouts help), and stones or recurrent UTIs happen in a minority. Long-term follow-up is essential.
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Oncological outcomes match ileal conduit
The cancer treatment is the cystectomy itself - the diversion type does not affect survival. Choose based on lifestyle, fitness and preference.
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Red flags
Fever, flank pain, no urine output, sudden severe abdominal pain or a distended painful pouch after surgery are not normal - contact the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever diversion was performed, the note the reconstructive urologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Diagnosis and diversion chosen
Why the cystectomy was done - cancer stage, benign indication - and which diversion (Studer, Hautmann, ileal conduit) was agreed with you.
- 02 Technique
Surgical technique and length of bowel
Open, laparoscopic or robotic approach. How much ileum was used, the ureteric implantation, the urethral anastomosis, and blood loss.
- 03 Findings
Pathology, margins and lymph nodes
Final tumour stage, whether margins were clear, how many lymph nodes were positive, and any incidental findings on the specimen.
- 04 Impression
Follow-up, imaging and continence plan
Read this first: catheter removal date, cystogram schedule, continence training plan, bicarbonate and B12 monitoring, and oncology follow-up.
Recognised by major UK insurers
Cover for radical cystectomy with reconstruction varies by insurer and by indication - usually funded for cancer, self-pay for non-cancer indications. Most patients are treated on the NHS at a specialist urological cancer centre. We confirm cover and pathway before booking.
Frequently asked
Everything patients ask about neobladder reconstruction.
Quick answers on candidacy, continence, cost, self-catheterisation, and long-term complications.
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What is a neobladder?
A neobladder is a new bladder built from a 40–60 cm segment of your own small bowel (ileum). It sits inside the pelvis where the old bladder was, is connected to the ureters and the urethra, and lets you pass urine the natural way rather than through a stoma.
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Am I a candidate for a neobladder rather than an ileal conduit?
You need to be fit for a long operation, have adequate kidney function, have no cancer at the urethral margin, have a normal external sphincter, be motivated to manage continence training, and be willing to self-catheterise if needed. Most people over 75, and those who are frail or have complex comorbidities, are usually better served by an ileal conduit.
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How much does neobladder reconstruction cost privately in the UK?
Roughly £30,000–£55,000 for radical cystectomy with a neobladder, £25,000–£45,000 with an ileal conduit, and £30,000–£50,000 with an Indiana pouch. Robotic cystectomy adds £4,000–£8,000. On the NHS the procedure is funded at specialist urological cancer centres. We confirm a firm quote within one working day.
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How long is the operation and the hospital stay?
The operation takes 6–10 hours. You spend 24–48 hours in ITU or HDU and 10–14 days in hospital in total. You go home with a urethral and a suprapubic catheter, both removed at 3–4 weeks after a cystogram confirms the neobladder has healed.
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Will I be continent?
By 12 months around 90% of patients are continent during the day. Nocturnal continence is trickier - 60–80% are dry at night, and most people wake once or twice to void. Pelvic-floor physiotherapy after catheter removal makes a real difference.
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Will I have to catheterise myself?
Some patients (10–30%) cannot empty the neobladder fully and need clean intermittent self-catheterisation - either occasionally at night, or daily. You are taught the technique before catheters come out, so you are prepared either way.
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What are the long-term complications?
Metabolic acidosis (managed with oral bicarbonate), B12 deficiency (checked yearly and replaced if needed), ureteric stricture, stones in the pouch, mucus production needing occasional washouts, recurrent UTIs, and - rarely - pouch rupture from over-distension. Long-term follow-up is essential.
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Where in the UK is this operation done?
At high-volume specialist urological cancer centres - for example Queen Elizabeth Birmingham, UCLH, Guy’s, Southampton, Manchester and Leeds. Volume matters: outcomes are better where the reconstructive team does this operation regularly. We introduce you to a named consultant at one of these centres.
Related treatments
Looking for something else?
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Mitrofanoff
Continent catheterisable channel - an alternative diversion.
Learn more -
Nephrectomy
Kidney removal for cancer or non-functioning kidney.
Learn more -
Prostatectomy
Radical prostatectomy for localised prostate cancer.
Learn more -
All tests & procedures
Every test and procedure we arrange.
Learn more