How surgeons build a new bladder for cancer patients like Deion Sanders

At 57, two-time Super Bowl champion Deion Sanders, has a brand-new bladder.

The University of Colorado coach recently underwent reconstructive surgery to treat an aggressive form of bladder cancer after doctors discovered a tumor this spring.

The procedure, called neobladder reconstruction, uses tissue from the patient’s own small intestine.

Here’s how it’s done:

First surgeons remove the old bladder. Then they cut out about a foot and a half from the ileum, the end section of the small intestine.

Then the surgeon cuts down one side of the segment of intestine so that it lays flat like a sheet. Next, they fold it in half, top to bottom, and then connect the back part to the front.

The end result resembles a volleyball covered in sutures, said Dr. Max Kates, codirector of the Greenberg Bladder Cancer Institute at Johns Hopkins University.

Finally, the surgeon sews the neobladder to the kidneys and urethra.

The human body’s ability to adapt to such a procedure is “amazing,” says Sanders’ surgeon, Dr. Janet Kukreja, director of urologic oncology at the University of Colorado Cancer Center. Patients usually spend just a few days recovering in the hospital.

She performed Sanders’ neobladder reconstruction robotically and with a laparoscopic camera, a method that only requires small incisions.

Kukreja told NPR that a cool aspect of this surgery is that because the neobladder is created from the body’s own tissue, a patient’s immune system doesn’t reject the new organ. So patients with neobladders don’t need immunosuppressant medications.

Plastic wouldn’t work either to reconstruct a bladder since the urinary tract rejects foreign materials, said Kukreja. Calcium would build up giving patients bladder stones.

A reconstructed bladder doesn’t function exactly like someone’s original bladder because it can’t send signals to the brain to let a person know when to use the toilet.

Getting used to a neobladder takes some training, says Dr. Jodi Maranchie, a surgical urologic oncologist at UPMC in Pittsburgh. Gradually they increase the interval between bathroom visits until they can comfortably control their bladder during the day. But leakage often remains an issue for people while they sleep.

During a Monday press conference, Sanders acknowledged this drawback. He joked that, like his one-year-old grandson, he now “depends on the Depends.”

“I know there’s a lot of people out there going through what I’m going through. And dealing with what I’m dealing with,” he said. “And let’s stop being ashamed of it.”

Kates said a lot of people do feel shame around the incontinence that comes with a neobladder reconstruction.

Which is why Kates told NPR that he “loved every moment” of Sanders’ press conference. The urologist described the Pro Football Hall of Famer as authentic and funny, “the guy was anything but shameful.”

In fact two of Kates’ patients, both men around Sanders’ age, mentioned the press conference: “They both felt completely validated by him.”

An estimated 85,000 people in the U.S., will get bladder cancer this year, according to data from the American Cancer Society. While most patients with bladder cancer are men, Maranchie said that women tend to present with a more advanced and slightly more aggressive disease.

Because the only symptom of bladder cancer is blood in urine, she theorized that some women mistake this warning sign for menstrual blood.

But Sanders shared that his tumor was discovered during an annual checkup.

He said if he hadn’t gone in for that appointment, things might have turned out very differently.

“Please get yourself checked out,” he said. “Because if it wasn’t for me getting tested for something else they wouldn’t have stumbled up on this. Make sure you get the right care.”