Hi, again, Ellen,
Here is a reference excerpt and link that I thought you might find worth reading:
"Bladder Substitution in Women"
Alan Doherty, MD, Fiona Burkhard, MD, Stephan Holliger, MD, and Urs
Studer, MD
Current Urology Reports 2001, 2:350-356
"Reservoir shape and size
We construct a detubularized ileal pouch as previously described [26]. This technique is the same for men and women. The pouch has a spherical shape, which maximizes its volume for a given surface area. The initial pouch has a capacity of 125 to 160 mL. A well-instructed patient is expected to increase this to 500 mL within 2 to 3 months. A capacity of about 500 mL is important to minimize incontinence episodes. If patients, through fear of urinary incontinence, void more frequently than instructed, they remain with a low-capacity reservoir with high-pressure characteristics. This inevitably leads to nocturnal and sometimes also diurnal incontinence."
and
"Postoperative Care
A fully functioning bladder substitution needs a motivated patient and meticulous postoperative surveillance. The aims of management are to:
Prevent residual
Prevent infection
Prevent acidosis
Expand the pouch
Encourage drinking and salt intake for the first month
Initially, patients are instructed to void every 2 hours, first by sitting while relaxing the pelvic floor and, if necessary, by abdominal straining without pressing downward. Patients without metabolic disturbances are instructed to retain urine for 3 and then 4 hours. Patients are told not to be despondent by episodes of incontinence or dribbling. Usually, incontinence occurs during periods of high intravesical pressure and is more common when the pouch capacity issmall (Laplace's law). Most patients find it easy to understand that high intravesical pressure is required to expand the reservoir. In this way, a bladder capacity of 500 mL can be reached, and continence will ensue. Many patients find this regimen difficult to adhere to. They fear incontinence and urinate frequently. The bladder remains of small capacity, and persistent nocturnal incontinence is inevitable.
Patients are told to avoid alcohol and sleeping pills because these relax the pelvic floor, which in turn leads to incontinence."
www.current-reports.com/article.cfm?PubID=UR02-5-1-02&Type=Article&KeyWords=#F.UR02-5-1-02.01
or
tinyurl.com/7ljos
Although this report listed stretching the neobladder over 2 to three months, I was able to do so in just a couple of weeks. From others, I think the amount of time it takes does vary considerably among individuals. Please keep me posted on how you are doing.
My best to you,
LindaW