What is transurethral resection of a bladder tumor (TURBT)?
TURBT is a medical procedure which is performed to establish the type of bladder tumor present and potentially diagnose bladder cancer.
A bladder tumor is a growth that starts in the lining of the patient’s bladder. Bladder tumors can bleed, causing blood in the urine. Sometimes blood clots can form, which may block the patient’s bladder from emptying. One may have a burning sensation when he passes urine or may need to pass urine more frequently.
Bladder tumors are either:
- Non-invasive tumors - which tend to stay in the lining of the patient’s bladder. This type of tumor isn’t cancerous but could change into a cancerous one.
- Invasive tumors - are cancerous, they grow into and through the bladder wall. The cancer can spread to other parts of the body.
The surgeon will remove tissues and examine them under a microscope to find out the type of tumor the patient has. The surgeon can also perform biopsies (removing small pieces of tissue) on areas of the bladder that appear normal but are more likely to form tumors.
What are the benefits of transurethral resection of a bladder tumor (TURBT)?
The patient’s symptoms should improve. Resecting (scraping away) a superficial bladder tumor should remove it completely and reduce the risk of the patient developing invasive cancer.
If the patient is having an invasive cancer, a TURBT will not remove the cancer completely. However, examining the tissue under a microscope will help the surgeon to recommend the best treatment for the patient.
Are there any alternatives to TURBT?
Resecting the tumor is the only dependable way to find out the type of tumor the patient has. If the patient doesn’t undergo the operation and the tumor is superficial, there is a risk that it will change into a cancerous one.
If the tumor is cancerous, there is a risk that the tumor will grow deeper into the tissues of the patient’s bladder and cancer may spread to other parts of his body.
What happens during the operation?
Resecting a bladder tumor is performed under a general or spinal anesthesia. The anesthetist will discuss the options with the patient and will recommend the best form of anesthesia for him. The operation usually takes less than 30 minutes.
The surgeon will pass a resectoscope (a small operating telescope) into the patient’s bladder through his urethra (the tube that carries urine from the bladder). The surgeon will use the resectoscope to identify and resect any tumors. They will seal the raw areas with an electric current (cauterization) and will sometimes use the resectoscope to perform biopsies.
At the end of the operation, the surgeon will remove the resectoscope and will place a catheter (tube) in the patient’s bladder. This will allow the patient to pass urine easily and for the bladder to be washed out with fluid to prevent blood clots.
The following lifestyle changes can help to make the procedure a success:
- Some pain is common with most operations
- Bleeding after surgery
- Infection, which may need treatment with antibiotics
- Making a hole in the bladder. The risk increases if the surgeon needs to scrape into the wall of the bladder to remove a tumor. It usually takes a few days for the hole to heal, if the catheter is draining well. If the hole does not heal, one may need surgery
- Narrowing of the urethra, caused by scar tissue forming. If this happens, one may need further surgery.
This is not a definitive list and symptoms will vary with each patient. Please ask the consultant for more information.
What is involved in the recovery?
The catheter will usually be removed after one to two days. One should be able to go home after the catheter has been removed and he has passed urine. However, the doctor may recommend that he will stay a little longer. Remember, the patient won’t be able to drive after the operation.
The patient may experience a little stinging sensation for the first few times he passes urine. Drink plenty of water, as this will help the patient to pass urine more easily and will reduce the risk of developing blood clots. One should be able to go back to work after about two weeks.
It is normal to get blood in urine every now and then while any raw areas in the patient’s bladder heal. The patient may need to come back to the hospital to have a blood clot removed using a catheter. Regular exercise should help the patient’s recovery.
The patient will need to come back to the clinic for results from the examination of the tissue that the surgeon removed.