Ileal conduit and abdominal reservoir diversions require either a plastic bag or a catheter to remove the urine. The Neobladder gives the individual the ability to train themselves to hold the urine and release the urine from their newly built (neo) bladder. This process may take months to learn how to hold the urine in and then empty out with muscle control.
 
Ileal conduit and abdominal diversion reservoirs take little training to use compared to the Neobladder. The Neobladder is created by your surgeon with pieces of your intestine. The flow of urine now travels from your kidneys to your two ureters into the Neobladder and then out of your body through your urethra which has been attached to the Neobladder. 

The difference is that your new bladder does not have nerves and muscles that squeeze the urine out of the bladder or nerves and muscles that hold the bladder and urethra shut to keep the urine from leaking out during the day. By learning how to control the muscles that lie at the base of the bladder and surround the urethra you can practice strengthening them so they will hold the urine in more consistently and any leakage will be minimized. These kegel exercises will start once the catheter is removed several weeks after the cystectomy.

Once you go home your Neobladder needs to be rinsed out during the day to remove mucus from the inner lining of your new bladder. You will have a catheter which will be used to not only allow the urine to leave your bladder but by using a large syringe ( the size of a cooking baster) sterile water will be slowly injected up the catheter into the Neobladder and then withdrawn drawing out mucous along with the water. Over time your Neobladder will be cleared of mucus.

Which ever urinary diversion is created after your cystectomy, with time and experience, your lifestyle will come back to what it was with a few modifications. Having cancer, surgery, adjusting your toileting methods, and altered self image, sounds like a tall order to handle, but 75% of cystectomy patients are cancer free after five years, the surgical site heals, your toileting routine becomes second nature, and your personal experiences and relationships will continue to grow.