A transurethral resection of a bladder tumor (TURBT) is a procedure that involves both a biopsy and tumor removal. TURBT is done through the urethra and can help prevent cancerous cells from invading the muscle wall.
Patients with early stage bladder cancer can undergo TURBT for diagnosis and treatment. Most patients with bladder cancer haven’t had cancerous spread to the muscle wall at diagnosis, making TURBT an effective first-line diagnosis and treatment.
The biopsy portion of TURBT involves taking a tissue sample from the cancerous area and removing as much cancerous growth as possible.
How to Prepare for TURBT
Patients will need to stop eating and drinking the night before the procedure, since TURBT is performed under anesthesia. The physician doing the operation will need to know which medications the patient is taking, including over-the-counter medicine and supplements. Patients may need to stop taking blood thinners prior to surgery, but should check with their physician before stopping medication. If the physician allows the patient to take medication before surgery, only one or two sips of water may be taken.
It’s important to avoid using lotions, perfumes, and deodorants the day before surgery. Patients will need to arrange for a friend or family member to drive them home from the operation.
What to Expect During the Procedure
The patient will be placed under general anesthesia before the surgeon can begin the procedure.
The surgeon will start by inserting a rigid instrument, called a resectoscope, into the bladder through the urethra. This method doesn’t require any incisions. Next, he will use the resectoscope to remove the tumor which will then be sent to a lab for testing. Once the tumor has been removed, the surgeon will use fulguration or cauterization to burn the remaining cancerous cells.
In some cases, the surgeon may use a scope to insert chemotherapy medication into the bladder through a process called intravesical chemotherapy. The patient may be referred for maintenance intravesical chemotherapy for routine treatment.
The Recovery Process
After the procedure, the patient will have a catheter in their bladder to help drain urine. It’s normal to temporarily have blood in the urine. The catheter will be removed once the patient no longer has any visible blood in their urine or when they’re discharged.
To prevent infections and flush out the bladder, patients should drink lots of liquids. They’ll be able to drink and eat as usual, without any restrictions.
Most patients can undergo a simple TURBT as an outpatient procedure, but some patients may need to stay overnight if they have other coexisting medical conditions or a large amount of tissue removed.
Patients may experience discomfort when urinating, but should be able to resume normal activities within a few days.
The physician will determine the best course of further treatment for each patient depending on the size of their tumor and personal medical history.
Potential Risks
Though TURBT is a very safe procedure, there is a risk of complications, such as urinary tract infections, excessive or prolonged bleeding, reactions to the anesthesia, and perforation in the bladder.
