Orthotopic Neobladder Reconstruction in Turkey: VISA Assistance & Local Travel Guide

Orthotopic Neobladder reconstruction is a specialised surgical procedure that reconstructs the bladder and restores its function following partial or complete bladder removal due to conditions like bladder cancer. This advanced form of urinary diversion is recommended after a cystectomy to help re-establish normal urinary function and improve quality of life.

However, the cost of neobladder reconstruction is very high in countries such as Spain, Germany, the USA, and the UK. As a result, many patients start looking for high-quality and affordable treatment abroad, with Turkey as one of the most preferred and visited medical tourism destinations.

In Turkey, cities like Istanbul, Antalya, and İzmir offer state-of-the-art medical facilities and experienced urologists who specialise in neobladder reconstruction, often at lower prices than in Western countries. Beyond its reputation as a medical tourism hub, Turkey also offers travellers the chance to have a perfect vacation. This page will inform you of everything about orthotopic neobladder reconstruction surgery in Turkey, including its costs and visa applications.

What is an Orthotopic Neobladder Reconstruction? 

Orthotopic neobladder reconstruction is a complex procedure that creates a new bladder after the original has been partially or completely removed, often due to bladder cancer. This is done using a segment of the patient’s own intestine to form a new bladder, which is then connected to the urethra for more natural urination.

Turkey offers lower costs for orthotopic neobladder reconstruction compared to many Western countries. However, before undergoing the procedure, it's important to understand what it entails.

Surgeons generally perform the surgery through an open or minimally invasive method. They reconstruct the bladder through tissues taken from nearby areas, like a part of the small intestine. Then, the new bladder is linked to the ureters and urethra to restore a person’s urinary function.

Turkey’s advanced medical facilities, qualified surgeons, and affordable healthcare options make it the perfect destination for this type of reconstructive surgery.

What are the Benefits of Orthotopic Neobladder Reconstruction ?

Neobladder surgery is usually suggested when the original bladder does not function as it should. Also, if no medication or therapy can help reduce or address bladder problems or ailments, neobladder reconstruction is the only method that can be used as a last resort. Here are some advantages of neobladder reconstruction:

■ Preserved Body image:

With neobladder reconstruction surgery, there is no need to carry an external collection bag that can adversely affect one’s body image. This surgery preserves one’s body image and confidence in social situations.

■ Natural urination:

This method is also beneficial in terms of facilitating natural urination through the urethra, which is not possible in other treatment options. This closely replicates normal bladder function and eliminates the need for external appliances, making daily life more convenient.

■ Improved lifestyle:

Patients who undergo neobladder reconstruction retain greater physical freedom to engage in activities like swimming, sports, and sexual activity. It supports a more active and unrestricted lifestyle compared to other forms of urinary diversion.

■ Better urinary continence:

Many patients report good daytime and nighttime urinary incontinence after the procedure. However, this requires effective bladder problem management strategies such as pelvic floor exercises and can also vary from one patient to another.

■ High long-term satisfaction:

Another benefit of neobladder reconstruction is the reported high levels of patient satisfaction. Most patients who underwent an orthotopic neobladder procedure report long-term satisfaction regarding quality of life, especially when compared to alternative diversion methods.

What Are the Types of Orthotopic Neobladder?

Primarily, there are eight types of orthotopic neobladders based on their shapes. and configuration of the intestinal segment. Here are the orthotopic neobladder types:

1. Studer Neobladder:

The Studer pouch is the most commonly used orthotopic neobladder today. It is constructed from a detubularized segment of the ileum, which is about 50 - 60 cm, folded in a U-shape, and sutured into a spherical reservoir. The ureters are implanted into a short afferent limb to reduce reflux. This type of neobladder is used in both open and robotic cystectomy, and you get long-term continence rates and natural urination via the urethra.

2. Hautmann Neobladder: 

Constructed using about 70 cm of ileum, the Hautmann pouch folds the intestine into a W shape and sutures the segments to form a reservoir. The ureters are implanted into the posterior wall of the pouch. This neobladder is used in high-volume centres and provides a low-pressure reservoir with good continence.

3. Camey I & II Neobladder:

One of the earliest designs, the Camey I and II neobladders are constructed from a U-shaped segment of ileum. In Camey II, modifications are made to improve storage and void function by detubularizing the bowel segment and optimising its shape.

4. Kock Pouch: 

The Kock pouch was first developed for continent cutaneous diversion, but it has since been changed for orthotopic use. It has a valve mechanism made from the intestine that stops reflux and keeps the person from leaking.

5. T-Pouch:

The T-pouch is a variation of the Kock design. It has a T-shaped design and includes an afferent limb for connecting to the ureter. It aims to maximise capacity and continence while keeping the pressure low. The procedure provides long-term results and keeps the upper urinary tract working well.

6. Modified Camey II:

The modified Z-shape is a more advanced version of the Camey II. Its goal is to make the neobladder bigger and better at emptying. Z-folding and detubularization make the pouch more flexible.

7. Abol-Enein and Ghoneim Modification of the W-Pouch:

This method uses a modified version of the Hautmann W-shaped pouch to implant the ureters in serous-lined extramural tunnels. This stops reflux and protects kidney function.

8. Vesica Ileale Padovana:

This neobladder was developed in Padua, Italy. It uses a circular folding method that closely mimics the natural bladder's round shape. This method helps evenly distribute pressure, supports good voiding function, and has led to great long-term outcomes for patients.

What are the Indications for Orthotopic Neobladder Reconstruction in Turkey?

Certain factors show the need for an orthotopic neobladder reconstruction. In Turkey, this advanced procedure is performed at internationally accredited hospitals with experienced urologic surgeons. Here are some primary indications for orthotopic neobladder:

• Bladder cancer:In bladder cancer cases where radical cystectomy is a must, neobladder reconstruction is essential for a more natural form of urinary diversion.
• Benign Bladder Conditions: Conditions such as refractory bladder dysfunction, neurogenic bladder, or severe interstitial cystitis lead to the need for bladder removal and subsequent reconstruction when other treatments fail.
• Non-Functional Bladder: When the bladder becomes nonfunctional due to chronic disease, prior surgeries, or trauma, and treatments like medication and catheterisation become ineffective, surgical reconstruction is required.
• Congenital Bladder Abnormalities: Certain congenital defects, such as bladder exstrophy or other severe malformations present from birth, sometimes necessitate bladder reconstruction for an improved quality of life and urinary function.
• Severe Urinary Incontinence: In select cases, patients with debilitating incontinence that cannot be managed with other treatments, benefit from neobladder reconstruction, especially if bladder removal is also indicated.

What is the Step-by-Step Procedure for Orthotopic Neobladder Reconstruction in Turkey? 

Neobladder reconstruction is a major surgery that is usually performed after a radical cystectomy. Here is the step-by-step procedure for an Orthotopic neobladder reconstruction surgery:

• The first step is the removal of a non-functional bladder, done through a radical cystectomy.
• Sections of the ileum are then carefully separated while preserving digestive function.
• The isolated intestinal segment is reshaped and sutured to form a reservoir, which mimics the shape and function of the original bladder.
• Finally, the newly fabricated bladder is located in place of the original one.
• The new bladder is then attached to the ureters and the urethra.
• The section of the intestine where tissue was taken is then repaired and reconnected for normal digestion.
• A temporary catheter is inserted through the urethra into the new bladder to help drain urine during the initial healing period.

How is Recovery After Orthotopic Neobladder Reconstruction in Turkey? 

Orthopaedic Neobladder Reconstruction in Turkey is a beneficial procedure for bladder reconstruction. It is a major procedure and requires several months for healing along with certain physical, emotional, and lifestyle adjustments. The recovery can be challenging as you will need time to adapt to the changes inside your body, such as emptying your bladder, raising it, building the pelvic floor muscles, etc. 

Here are some common tips for ensuring faster recovery and boosting an easy transition-

• Strictly adhere to your doctor’s instructions once you get discharged. 
• Take your medicines on time to avoid complications
• Drink plenty of water
• Avoid bladder irritants like coffee, alcohol, or even smoking
• Try to practice yoga and meditation if allowed by your doctor
• Use a painkiller drug if the bladder region aches
• Contact your primary healthcare provider if you notice any unexpected problems like pain, inflammation, or struggling with catheterised urination.  

What is the Cost of Orthotopic Neobladder Reconstruction in Turkey? 

The cost of orthotopic Neobladder reconstruction is relatively higher in Western countries than in countries like Turkey. Therefore, when you plan to go for a Neobladder reconstruction surgery, it’s wise to compare the prices before you decide on a country to get it done. Here is a brief Neobladder reconstruction cost comparison of Turkey vs. other countries.

Remember that the cost of the Neobladder reconstruction is subject to change depending on several factors, such as the location of the treatment, the reputation of the hospital and urologist, your underlying health conditions, and more. Also, if you are planning to undergo a Neobladder reconstruction, it would be wise to ask and compare prices and choose which one perfectly meets your budget and needs. 

Why Get Orthotopic Neobladder Reconstruction in Turkey? 

There is more than one reason to get your orthotopic neobladder reconstruction surgery done in Turkey. Turkish hospitals offer high medical expertise and are renowned for providing top-class treatments in an advanced medical infrastructure.:

■ Affordable Treatment Costs

One of the major advantages of choosing Turkey for your neobladder reconstruction is the lower cost of treatment when compared to countries like the U.S., UK, or Germany, and that is without compromising on quality. Full surgical packages are often offered at prices that are 30-70% less than in Western countries.

■ Specialised Medical Expertise

Turkish hospitals are staffed with highly qualified and internationally trained urologists and surgical teams, many of whom have studied or practiced in Europe and the U.S. The success rates of complex surgeries like neobladder reconstruction in Turkey are comparable to top Western countries.

■ Advanced Technology & Infrastructure

Hospitals in Turkey use state-of-the-art technology, including robot-assisted surgery, modern imaging systems, and internationally accredited operating facilities. The urology hospitals associated with CureTurkey are JCI-accredited, ensuring they meet global healthcare standards.

■ Recovery in a Travel-Friendly Country

After the surgery, patients can recover in comfortable hospital environments and enjoy a relaxing stay in historic cities like Istanbul, Antalya, or Izmir.