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Transurethral resection of bladder tumour (TURBT)

Transurethral resection of bladder tumour (TURBT) is a procedure used to diagnose bladder cancer and remove any unusual growths or tumours on your bladder wall.

You will meet the surgeon carrying out your procedure to discuss your care. It may differ from what is described here as it will be designed to meet your individual needs.

About transurethral resection of bladder tumour

Bladder cancer is caused by the uncontrolled growth of cells that line your bladder wall. If the cancer is just in the wall lining and hasn’t grown into the muscle of your bladder, it’s called superficial or non-muscle invasive bladder cancer. Non-muscle invasive bladder cancer can be treated by removing it from your bladder wall in a TURBT operation.

Before you have TURBT, you will usually have a procedure called a flexible cystoscopy, which is used to diagnose your cancer. Then (immediately after TURBT), if you have any tumours that appear to be non-muscle invasive, you will have bladder treatment with mitomycin C or Bacille Calmette-Guérin (BCG) to help prevent the cancer spreading or coming back.

What are the alternatives to transurethral resection of bladder tumour?

There are no alternatives to TURBT. This procedure is one of the first steps in diagnosing and treating bladder cancer.

Preparing for transurethral resection of bladder tumour

Your surgeon will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a chest and wound infection, which can slow your recovery.

TURBT is usually done under general anaesthesia. This means you will be asleep during the procedure. You will be asked to follow fasting instructions; not eating or drinking, typically for about six hours beforehand. However, it’s important to follow your anaesthetist’s advice.

At the hospital, your nurse may check your heart rate and blood pressure, and test your urine.

Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead, which you may be asked to do by signing a consent form.

Your nurse will prepare you for surgery. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may also need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings.

What happens during transurethral resection of bladder tumour?

The operation can take between 15 and 40 minutes.

Your surgeon will pass a thin, rigid, tube-like telescope called a cystoscope into your urethra (the tube that carries urine from the bladder out of your body) and into your bladder. He or she will then pass sterile fluid through the cystoscope into your bladder. This will make it easier for your surgeon to see your bladder wall. A camera lens at the end of the cystoscope will send pictures from the inside of your bladder to a monitor. Your surgeon will look at these images on the monitor to locate the unusual growth or tumours on your bladder wall.

Your surgeon will put a special wire loop through the cystoscope. Using the loop, he or she will cut away the tumour and a border of healthy tissue around it. Your surgeon may also pass an electric current down the wire loop to seal the wound. He or she will then take the cystoscope out and pass a thin, flexible tube (catheter) into your urethra. This will be left in place for about 24 hours.

Your surgeon may treat your bladder with mitomycin C (a chemotherapy medicine) to make sure any remaining cancer cells are destroyed. Alternatively, you may have this a few hours after the surgery.

The tissue removed in the procedure will be sent to a laboratory for testing.

What to expect afterwards

You will need to rest until the effects of the anaesthetic have passed and you may need some pain relief.

Your nurse will check your catheter and monitor your blood pressure and heart rate. The catheter may be connected to a system that washes any blood and blood clots out of your bladder. This is called bladder irrigation. You may also be given antibiotics to help prevent infection.

You will probably need to stay in hospital for between one and three days. Before you go home the catheter will be removed and you will be given a date for a follow-up appointment. You will need to arrange for someone to drive you home – try to have a friend or relative stay with you for the first 24 hours.

Recovering from transurethral resection of bladder tumour

Drink plenty of clear fluids over the first couple of days to help flush your bladder and reduce your risk of getting a urinary infection. If you have been prescribed antibiotics, it’s important to complete the whole course.

If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Don’t do any heavy lifting, strenuous exercise or driving in the first two weeks after your surgery. If you’re in any doubt about driving, contact your motor insurer so that you’re aware of their recommendations, and always follow your surgeon’s advice. It’s important you take time to recover properly from the operation and don’t rush into anything you feel you can’t manage.

What are the risks?

As with every procedure, there are some risks associated with TURBT. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects

Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of TURBT include:

  • pain and discomfort in your bladder and urethra – this usually settles after a day or two
  • blood in your urine – this may last up to two weeks

Contact your doctor for advice if you have:

  • a fever – a temperature higher than 37.5°C
  • severe pain or pain that lasts for more than 48 hours
  • a burning sensation when passing urine or having unpleasant smelling urine
  • heavy, blood-stained urine with clots

Complications

Complications are when problems occur during or after the procedure. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in your leg (deep vein thrombosis, DVT).

Complications of TURBT can include:

  • a urinary tract or bladder infection
  • difficulty passing urine
  • damage to your urethra, bladder or bladder wall – you may require further surgery

If the tumour isn’t completely removed or it reoccurs, you may need to have another TURBT operation.

Ask your surgeon if you need more information about the complications of TURBT.

 

Produced by Krysta Munford, Bupa Health Information Team, November 2012.

For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.


  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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