Objective: The relationship between histological changes and urodynamic findings emerging in neobladders (NBs) in a long term was not previously investigated. This study aimed to investigate the relationship between histological changes and urodynamic findings in the NB. Materials and Methods: Patients undergoing radical cystectomy and Studer NB were included in the study. Patients with follow-up times <48 months were assigned to group 1 (n = 5) and those with follow-up times >48 months in group 2 (n = 6). Metabolic, endoscopic, histologic, urodynamic, and continence parameters were evaluated after surgery. Results: No metabolic disorders or pathology was observed in the endoscopy of any patients. Histological evaluation revealed a decreased chronic inflammation and villus length severity over the years, with increased goblet cell numbers and fibrosis rates. Maximum reservoir capacity, compliance, and voiding pressure values for groups 1 and 2 were 418±42.1 and 401.33±67.8 mL, 15.65±2.7 and 18.54±4.98 mL/cm H2O, and 28.2±2.28 and 30.6±7.4 cm H2O, respectively. Maximum reservoir capacity was higher in group 1 than in group 2, whereas compliance and voiding pressure were lower, without significant differences (p = 0.84, p = 0.64, and p = 0.97; respectively). Conclusion: No effects were observed on urodynamıc parameters resulting from the development of long term histological changes in the NB. However, the NB appeared to adapt to its new function by gradually assuming a similar morphology to the urothelium, maintaining a sufficient capacity and compliance. Daytime continence was achieved at a rate of 90.9%, without metabolic pathology. [ABSTRACT FROM AUTHOR]