TURBT (Transurethral Resection of Bladder Tumor)
What is TURBT (transurethral resection of bladder tumor)?
Transurethral resection of bladder tumors (TURBT) is a treatment used by healthcare providers to identify and treat bladder cancer simultaneously. During TURBT, a physician uses a long, thin tool with a camera attached (cystoscope) to locate and remove the tumor from your bladder. Your doctor takes the tumor to a lab, where a pathologist examines it. This helps to assess its stage (how far it has penetrated your bladder wall) and grade (how different the cells appear from normal cells). For TURBT, your provider does not need to create any incisions; the scope enters your bladder via your urethra (the tube through which your urine exits your body).
Why is TURBT done?
When a tumor in your bladder needs to be biopsied and/or removed, your provider will conduct a TURBT. It enables your doctor to use a single procedure to remove and biopsy (obtain tissue samples from) the tumor.
Procedure Details
What happens during the TURBT procedure?
Your clinician may administer general anesthesia prior to a TURBT operation, causing you to fall unconscious. Some clinicians prefer regional (or spinal) anesthesia. This implies you’ll be awake, but your bottom half will be numb. To conduct the TURBT, your surgeon will:
- Insert the scope into your bladder through the urethra. Use a little cutting device to locate and remove the tumor.
- Following the procedure, a pathology lab will evaluate it. Apply heat to stop any bleeding from the tumor resection site.
- Remove the scope and implant a catheter as needed. This removes your urine and other fluids from your bladder, preventing blood clots. Your doctor may also use the catheter to flush your bladder with saline (a sterile salt solution). Some people do not require a catheter.
How painful is the TURBT?
You should not feel any pain during a TURBT operation. After the surgery, you may experience pain or discomfort for a week or two, particularly when peeing.
Do you need chemotherapy following TURBT?
Some patients may require chemotherapy following TURBT. If the tumor has not moved outside of your bladder, your doctor may choose intravenous chemotherapy — medicine delivered directly to your bladder via a catheter — after TURBT. During the TURBT operation, the first dose of chemotherapy may be administered to the inside of your bladder after the tumor has been removed. Additional therapies would begin in the weeks following TURBT. If cancer has spread (metastasized), you may receive chemotherapy via an IV to treat your entire body.
Do you stay in the hospital following TURBT?
Following TURBT, you will be monitored for a few hours at the hospital. If you have a catheter, they may remove it before you leave home. Depending on the size of the tumor and the amount of blood in your pee, the catheter may remain in place for a few days after you return home. After returning home, it’s important to follow your provider’s recommendations for fluid intake. You can eat and drink as you normally would. You will have a follow-up visit or be contacted by your provider on the biopsy results. Ask your provider when you can expect results and how you will obtain them.
Risks / Benefits What are the benefits of TURBT?
The primary benefit of TURBT is that it can biopsy and treat cancers that have not migrated beyond of your bladder. This decreases the number of procedures and associated dangers.
What are the potential dangers and consequences of TURBT?
Bladder tumor biopsy and excision are extremely safe procedures. However, it is not without hazards, just like any other surgery. Risks associated with anesthesia include allergic reactions and breathing issues.
- Urinary tract infections (UTI)
- Excessive or prolonged bleeding
- Bladder injuries.
Recovery and Outlook
How long does it take to recover after TURBT?
It can take up to six weeks to feel completely recovered after a TURBT procedure. During the first week or two, you should prioritize rest. You may experience pain or burning when you urinate. Your provider can advise you on how to deal with any discomfort. You might notice a small amount of blood in your urine. This is normal, but notify your provider if you see more blood than expected. Should not strain or lift heavy objects. Your provider may also advise you against driving. Your provider will let you know when you can expect to resume your normal level of activity. They usually recommend waiting at least two weeks before gradually returning to your regular activities.
Second-look TURBT
You could require a second TURBT surgery (also called a second-look TURBT) to lower your chance of cancer spreading outside your bladder, and to make sure that all the tumor was removed during the first TURBT. This normally happens four to six weeks following the first treatment.
When To Call the Doctor
When should I call my healthcare provider?
Contact your provider if you have any questions before or after your operation. Let them know right away if you have:
- Fever
- Bloody, cloudy or foul-smelling pee
- Unexpected or intense discomfort
- Excessive amount of blood in your pee
- Large blood clots in your pee