Immediately after neobladder creation, what is the typical capacity, and what strategy helps increase it?

• A. Capacity is large immediately post-op.
• B. Capacity is small immediately post-op; scheduled voiding helps increase volume.
• C. Capacity is large and remains unchanged.
• D. Capacity is small and voiding should be avoided.

Answer: (B)

After a neobladder is created, the reservoir is usually small right away because the ileal segment is still healing and not yet stretched. Over time, with use, the pouch becomes more compliant and its capacity increases. The key strategy to promote this growth is scheduled voiding (habit training). By voiding at regular, planned intervals, the pouch is regularly emptied and gradually stretched, which raises its usable volume and helps improve continence. Start with frequent intervals (for example every 2–3 hours) and lengthen them as capacity improves. Avoid waiting for urge or letting long delays occur, as that can lead to overdistension.