{"id":12798,"date":"2025-07-31T10:50:15","date_gmt":"2025-07-31T14:50:15","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/neobladder\/"},"modified":"2026-10-06T12:50:55","modified_gmt":"2026-10-06T16:50:55","slug":"neobexiga","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/neobexiga\/","title":{"rendered":"Neobexiga"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[112],"glossary-product":[],"class_list":["post-12798","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-surgical-procedures"],"acf":{"gt-definition":"<p>A neobexiga \u00e9 um reservat\u00f3rio de urina criado cirurgicamente a partir de tecido intestinal ap\u00f3s a remo\u00e7\u00e3o da bexiga (cistectomia). Essa t\u00e9cnica de deriva\u00e7\u00e3o urin\u00e1ria ortot\u00f3pica consiste em reconfigurar segmentos do intestino delgado, geralmente o \u00edleo, em uma bolsa esf\u00e9rica que funciona como bexiga substituta.<sup>1<\/sup> A neobexiga \u00e9 posicionada no local original da bexiga e conectada aos ureteres (que transportam a urina dos rins) e \u00e0 uretra, permitindo o armazenamento da urina dentro do corpo e a mic\u00e7\u00e3o volunt\u00e1ria pelo canal uretral natural.<sup>2<\/sup> O principal objetivo da neobexiga \u00e9 manter a contin\u00eancia e preservar a qualidade de vida, permitindo que os pacientes urinem de forma semelhante \u00e0 fun\u00e7\u00e3o fisiol\u00f3gica normal ap\u00f3s a remo\u00e7\u00e3o da bexiga.<sup>3<\/sup> Com o tempo, o tecido intestinal passa por um processo de matura\u00e7\u00e3o, com altera\u00e7\u00f5es estruturais e ultraestruturais na mucosa ileal que levam a um epit\u00e9lio primitivo semelhante ao urot\u00e9lio, aprimorando sua fun\u00e7\u00e3o como reservat\u00f3rio urin\u00e1rio.<sup>4<\/sup><\/p>","gt-synonyms":"Neobexiga ortot\u00f3pica, Neobexiga ileal, Deriva\u00e7\u00e3o urin\u00e1ria ortot\u00f3pica, Deriva\u00e7\u00e3o urin\u00e1ria continental, Substitui\u00e7\u00e3o da bexiga, Neovesica","gt-citation":"[1] Chesnut GT, Rentea RM, Leslie SW. Urinary Diversions and Neobladders. StatPearls. 2024. PMID: 32809318. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK560483\/\n\n[2] Hautmann RE. Urinary diversion: ileal conduit to neobladder. J Urol. 2003 Mar;169(3):834-42. DOI: 10.1097\/01.ju.0000029010.97686.eb.\n\n[3] Barone B, Napolitano L, Reccia P, et al. Advances in Urinary Diversion: From Cutaneous Ureterostomy to Orthotopic Neobladder Reconstruction\u2014A Comprehensive Review. J Pers Med. 2024;14(4):392. DOI: 10.3390\/jpm14040392. PMID: 38673019\n\n[4] Palleschi G, Pastore AL, Ripoli A, et al. Urodynamic assessment of orthotopic urinary diversions. Front Urol. 2022;2:885826. DOI: 10.3389\/fruro.2022.885826.\n\n[5] Cleveland Clinic. Bladder Reconstruction Surgery (Neobladder): Procedure. Updated April 24, 2024. https:\/\/my.clevelandclinic.org\/health\/procedures\/bladder-reconstruction-surgery.","gt-clinical-context":"<p>A reconstru\u00e7\u00e3o com neobexiga \u00e9 indicada principalmente para pacientes submetidos a cistectomia radical por c\u00e2ncer de bexiga m\u00fasculo-invasivo, que representa o tratamento mais eficaz, com taxas de sobrevida c\u00e2ncer-espec\u00edfica em 5 anos relatadas de at\u00e9 76%.<sup>1<\/sup> Outras indica\u00e7\u00f5es incluem dor vesical cr\u00f4nica ou disfun\u00e7\u00e3o da bexiga decorrente de les\u00e3o, cirurgia ou radia\u00e7\u00e3o que exija a remo\u00e7\u00e3o da bexiga.<sup>2<\/sup> A sele\u00e7\u00e3o de pacientes \u00e9 fundamental para o sucesso do tratamento; os candidatos ideais s\u00e3o indiv\u00edduos motivados, com fun\u00e7\u00e3o renal adequada, sem acometimento tumoral da uretra e com bom estado geral de sa\u00fade.<sup>3<\/sup><\/p>\n    \n    <p>O procedimento cir\u00fargico consiste na remo\u00e7\u00e3o da bexiga (cistectomia), geralmente com linfadenectomia p\u00e9lvica bilateral, seguida do isolamento de um segmento do intestino delgado (geralmente 40-60 cm de \u00edleo), preservando-se sua irriga\u00e7\u00e3o sangu\u00ednea.<sup>4<\/sup> Esse segmento intestinal \u00e9 ent\u00e3o reconfigurado em um reservat\u00f3rio esf\u00e9rico, posicionado no local original da bexiga e conectado aos ureteres e \u00e0 uretra.<sup>5<\/sup> O procedimento pode ser realizado por cirurgia aberta convencional ou por t\u00e9cnicas minimamente invasivas, como a cirurgia rob\u00f3tica, com tempo operat\u00f3rio que normalmente varia de 2-6 horas.<sup>5<\/sup><\/p>\n    \n    <p>No p\u00f3s-operat\u00f3rio, os pacientes precisam de um cateter urin\u00e1rio por aproximadamente tr\u00eas semanas para permitir a cicatriza\u00e7\u00e3o.<sup>2<\/sup> A recupera\u00e7\u00e3o envolve o aprendizado de novas t\u00e9cnicas de mic\u00e7\u00e3o com o uso dos m\u00fasculos abdominais e pode exigir exerc\u00edcios do assoalho p\u00e9lvico para melhorar a contin\u00eancia.<sup>5<\/sup> Os resultados cl\u00ednicos mostram que mais de 90% dos pacientes alcan\u00e7am contin\u00eancia diurna em 12-18 meses, enquanto mais de 50% alcan\u00e7am contin\u00eancia noturna em 18-36 meses ap\u00f3s a cirurgia.<sup>5<\/sup> Aproximadamente 10-15% dos pacientes podem precisar de autocateterismo intermitente devido \u00e0 dificuldade de esvaziar completamente a neobexiga.<sup>5<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":152},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Neobexiga Ortot\u00f3pica: Reconstru\u00e7\u00e3o Vesical | Rigicon<\/title>\n<meta name=\"description\" content=\"Entenda a neobexiga ortot\u00f3pica, reconstru\u00e7\u00e3o da bexiga com intestino ap\u00f3s cistectomia. 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