What is the first step when learning to void with a neobladder?

The first step when learning to void with a neobladder involves clamping the reservoir during the day. This practice allows patients to gain awareness and control over their bladder function, enabling them to identify the feeling of a full bladder. By clamping, it also encourages the patient to consciously time their attempts to void, which aids in developing a regular pattern.

In this early learning phase, it's essential for patients to focus on understanding their new bladder's function and how to respond to its signals. This approach not only fosters better bladder management but also aids in reducing the risk of involuntary leakage, often associated with this new urinary system.

The other options, while potentially relevant to managing a neobladder, do not align with the core objective of fostering awareness and control as the initial step in learning to void. For example, avoiding urination for extended periods can cause discomfort and may lead to complications. Using a catheter may be necessary in some cases, but it typically occurs after initial training and awareness are established. Attempting to void every 4 hours is a subsequent step that would follow the establishment of awareness, rather than being the first action taken in the learning process.