Bladder Surgery / TURBT

TUBRT is the procedure done to diagnose and to treat early stage bladder cancer at the same time. The initials stand for transurethral resection of a bladder tumor. This procedure is the first-line diagnostic test and treatment for bladder cancer. Men are almost four tTURBTimes more likely than women to be diagnosed with this type of cancer.

The majority of people have bladder cancer that hasn’t invaded the muscle wall when first diagnosed. Almost everyone diagnosed with bladder cancer will undergo bladder tumor biopsy and resection.

A biopsy is a procedure in which a doctor takes a tissue sample from the area where cancer may exist. During the biopsy procedure, the doctor also will try to remove the cancerous growth. This is called resectioning. The entire procedure for bladder tumor biopsy and resection is known as transurethral resection of bladder tumor (TURBT).

How do you prepare for a TURBT

You may have general anesthesia for this procedure, which means you’ll be asleep for it. Some providers might use regional (or spinal) anesthesia, which means you’ll be awake. However, you won’t feel any pain.

Bladder tumor biopsy and resection is performed when a doctor inserts a rigid instrument called a resectoscope into the bladder through the urethra. (This is the meaning of the word transurethral.) Inserting the resectoscope in this way means that no incisions are necessary.

Your provider will use the resectoscope to remove the tumor, which will be sent to a pathology lab for testing. Once the tumor is removed, your doctor will attempt to destroy any remaining cancer cells by burning the area using electric current by a process called fulguration or cauterization.

Your provider may decide to insert some type of chemotherapy medicine into the bladder using the scope. This is called intravesical chemotherapy. Your provider might suggest that you have maintenance intravesical chemotherapy for a period of time, meaning that you’ll have regular treatments.

What happens during the surgery

At the start of the procedure, you will be given a numbing drug (anesthetic). Generally, two options are available: general anesthesia where you take a nap for the entire procedure, or local anesthesia, where you remain awake, but are given a drug through a needle in your back to numb the lower half of your body.

During a TURBT procedure, the surgeon inserts a tool called a resectoscope through the urethra to reach the inside of your bladder. This tool has a surgical loop on it that resects or cuts off a sample of tumor tissue to be analyzed by a pathologist, or resects the entire tumor from your bladder (if it’s small enough). TURBT is used as a treatment for patients with early-stage bladder cancer, and is typically followed by intravesical therapy.

What happens after TURBT surgery

You will either go home the same day or stay in the hospital overnight. You will probably wear a small drainage tube called a catheter, to help drain your urine for a few days. You may also have to urinate more often. These side effects should go away with in two weeks of the operation. Be sure to tell your physician or nurse if you have any bleeding or pain. Your provider will need to know how much bleeding you have and will be able to give you medication to relax your bladder and avoid spasms.

Some patients will have intravesical chemotherapy in which the chemotherapy drug is delivered directly into the bladder through the catheter. The chemotherapy fills the bladder and destroys any microscopic tumor cells not removed by the surgery.

Risk

Bladder tumor biopsy and resection is a very safe procedure. However, like any surgery, it has some risks. These include:

Risks related to anesthesia.
Urinary tract infections.
Excessive or prolonged bleeding.
Perforation (or a hole) in the bladder.

If you have any symptoms such as fever, feeling cold and shivery, or heavy bleeding following bladder tumor biopsy and resection, you should seek medical help right away.

Recovery

Following the procedure, you’ll have a catheter (thin, flexible tube) inserted into the bladder to drain urine. It is normal for there to be blood in the urine at first. Drinking liquids will help flush out your bladder and help prevent infections. Your catheter will be removed when there is no more blood visible in the urine or when you go home.

Most people can have a simple bladder tumor biopsy and resection done as an outpatient procedure. However, your provider might suggest you stay overnight if you have other medical concerns or if you have had a large amount of tissue removed.

You should be able to drink and eat the way you normally do. You’ll probably be told to make sure you drink adequate amounts of fluids.

You might have some discomfort when you urinate.

You should be able to return to normal activity in a few days.