I. Regular urination Because the new bladder does not have the sensory function of the original bladder, you need to develop the habit of regular urination. Remember, not urinating for a long time is the cause of serious complications after in situ neobladder surgery. As the postoperative time increases, the capacity of the new bladder will gradually increase and you can urinate once every 2 hours during the day and you should set an alarm for once every 3 hours at night. If the blood gas analysis results show that the organism is well compensated, the voiding interval can be gradually extended, for example by 1 hour at a time, gradually rising from 2 hours to 3-4 hours. Patients must exercise to prolong the voiding interval thereby gradually increasing the bladder volume to an ideal volume of about 400-500 ml, which should be maintained even if incontinence occurs. The increased volume of the bladder can significantly improve the patient’s ability to control urine. However, the bladder volume should not be allowed to exceed 500 ml. In case of metabolic problems, the duration of urination needs to be shortened to reduce the absorption of toxins in the urine by the new bladder and to reduce the risk of infection. Second, urination position Patients can urinate in squatting or sitting position in the early stage of self-voiding, and if the urination is clear, you can try standing up to urinate. Relax the pelvic floor muscles during urination, and then slightly increase the abdominal pressure. Urination can be assisted by hand pressure on the lower abdomen and bending forward. Either method requires emptying of the bladder and therefore monitoring of the residual urine volume. Squatting and seated voiding are recommended based on the experience of previous patients. Patients with a new bladder are asked to remember that it is important to relax the pelvic floor muscles before increasing the abdominal pressure to urinate during voiding. Drink 2000-3000 ml of water daily The salt loss syndrome caused by a new bladder can cause hypovolemia, dehydration and weight loss if it is severe. It is therefore important to ensure a daily fluid intake of 2000-3000 after surgery (including a liquid diet of water, drinks, soup, etc.) and also to increase the salt intake in the patient’s diet. Frequent weight monitoring is recommended. Flocculation in the urine The bowel secretes mucus, so patients with neobladder surgery will have a certain amount of flocculation in their urine that is not a urinary tract infection. Usually the amount of mucus secreted by the bowel mucosa of the neobladder decreases over time and rarely causes urinary tract obstruction. However, if urinary tract infection and bacteriuria occur they need to be treated actively. Third, regular review Post-operative review of the new bladder allows proper patient guidance and early detection of adverse reactions, which is the key to ensure bladder function and avoid serious complications. Patients with neobladder are at risk of developing metabolic acidosis after surgery, which may manifest as drowsiness, fatigue, nausea, vomiting, anorexia, and abdominal burning if present. Monitoring alkaline residuals by venous blood gas analysis can provide an indication of acidosis. Some patients require a period of treatment with sodium bicarbonate (2C6 g/day) for correction. Postoperative tests are also required on a regular basis. For example (1) ultrasonography: to monitor residual urine volume and renal morphology; (2) cystourethrography and refluxography: to understand the morphology and volume of the new bladder, the presence of urethral strictures, and the presence of ureteral reflux; (3) intravenous urography: for the presence of hydronephrosis; (4) urodynamics: to understand the pressure, volume, and compliance of the new bladder; (5) cystourethroscopy: to understand the presence of recurrent urethral tumors. If there are symptoms such as thin urine line, difficulty in urination, lower abdominal bulge, back pain, fever, etc., it is necessary to consult the doctor promptly. The doctor will take treatment measures according to the specific situation, and delay in diagnosis and treatment may lead to serious consequences.