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Mike,
If you could go into my name and read #8 post it should help you with your decision.  I had a similiar situation after 4 months of chemo.  The MRI showed that my tumor had shrunk over half the size but the Dr.'s didn't know if it was scar tissue or still tumor in my bladder. My TUR of my bladder after chemo was negative.  They found no Ca cells in my bladder but the tumor was on the outside of my bladder into my uterus which they couldn't get at to biopsy very easily.  So I had to make the choice of bladder removal or just watch the tumor and see if it grows.  I choose to do the neobladder after a lot of thought. I really didn't want to lose my bladder I almost decided not to have the surgery and was willing to die to keep it.  But, I just came to peace with myself with some help from God and made my choice to have a neobladder. I really wasn't a real religious person before this happened to me but God did help me through and gave me the strength to go through it.
When they opened me my tumor was cancer and had gone into my uterus so they had to do a hysterectomy also with taking my bladder.  But my lymph nodes were clean, thank god and all my margins were clean.  I did make the right choice.  My life is pretty much back to normal.  My neobladder still leaks at night sometimes.  During the day I am almost dry unless I drink a lot of coffee.  I get tired faster then before my surgery but other then that life is good again.  I am so glad I can say I have it behind me.  I think the time between making the right decision and having the surgery is the most challenging.  If you have any questions please don't hesitate to contact me.
Dixie
Neobladder Johns Hopkins May 25, 2006