Published by Bupa's Health Information Team, November 2010.
This factsheet is for people who are having surgery to remove a bladder tumour, or who would like information about it.
Transurethral resection of bladder tumour (TURBT) is a procedure used to diagnose bladder cancer and remove any unusual growths or tumours on the 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.
Bladder cancer is caused by the uncontrolled growth of cells that line your bladder wall. If the cancer is just in the 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 the bladder wall in a TURBT operation.
There are no alternatives to TURBT. This procedure is the essential first step in diagnosing and treating bladder cancer. TURBT procedure is usually followed by bladder treatment with mitomycin C or Bacille Calmette–Guérin (BCG) to destroy any remaining cancer cells.
Very rarely, your bladder and surrounding tissues are completely removed. The procedure is called a complete or radical cystectomy. This is only done if the cancer is an aggressive superficial type which has a serious risk of progressing to muscle invasive disease.
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.
You will probably need to stay in hospital for two to three days. TURBT is usually done under general anaesthesia. This means you will be asleep during the procedure.
If you’re having a general anaesthetic, you will be asked to follow fasting instructions. This means 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 theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anticlotting medicine called heparin as well as, or instead of, wearing compression stockings.
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 to the outside) and into your bladder.
Sterile fluid will then be passed 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 to locate the unusual growth or tumours on your bladder wall.
Your surgeon will insert a special wire loop through the cystoscope and pass an electric current down the wire loop. The electric current is used to cut or burn off the growth or tumour and a border of healthy tissue around it. The electric current will seal the wound so you won’t need stitches.
Your surgeon may treat your bladder with mitomycin C to make sure any remaining cancer cells are destroyed. Alternatively, you may have this a few hours after the surgery.
Your surgeon will take out the cystoscope and pass a catheter into your urethra. This will be left in place for about 24 hours.
The tissue removed in the procedure will be sent to a laboratory for testing.
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
Your nurse will check your catheter and monitor your blood pressure and heart rate. The catheter may be connected to a system which washes any blood and blood clots out of your bladder. This is called bladder irrigation.
You may be given antibiotics to help prevent infection.
The catheter will be removed before you go home. 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 after you get home.
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 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.
Contact your doctor for advice if you have:
You may have developed a urinary tract infection (UTI) and may need further treatment.
There is a risk the bladder tumour may come back, so you will need to have regular cystoscopy checkups.
TURBT is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications.
Side-effects are the unwanted but mostly temporary effects you may get after having the procedure. Side-effects of TURBT include:
Complications are when problems occur during or after the procedure. Complications of TURBT are uncommon, but can include:
The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.
For answers to frequently asked questions on this topic, see Common questions.
For sources and links to further information, see Resources.
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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.
Publication date: November 2010
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