Transurethral Resection of Bladder Tumor (TURBT) is a common surgical procedure performed to address bladder tumors. This procedure serves a dual purpose: it helps diagnose the presence of bladder cancer and, in many cases, can remove the tumor itself. TURBT is a frequently utilized approach for patients with early-stage bladder cancer, allowing for tumor removal while aiming to preserve bladder function.
Preparing for TURBT Surgery
Before undergoing a TURBT procedure, patients receive instructions for a smooth and safe experience. Fasting is required for about eight hours prior to surgery. Patients must discuss current medications with their healthcare team, as blood thinners may need to be stopped up to a week before to minimize bleeding risks.
Pre-operative assessments include blood work, a chest X-ray, and an electrocardiogram (ECG) to evaluate health and suitability for anesthesia. A urine sample is collected to check for infections, which require antibiotic treatment before surgery. Patients must arrange for someone to drive them home after the procedure due to the effects of anesthesia.
What Happens During TURBT Surgery
The TURBT procedure takes between 15 minutes to an hour, depending on tumor size and number. Patients receive anesthesia for comfort, with options including general anesthesia (deep sleep) or regional (spinal) anesthesia (numbs lower body while awake). Antibiotics may be administered intravenously before the procedure to reduce infection.
The surgeon inserts a resectoscope, a thin, rigid instrument, through the urethra into the bladder. The resectoscope is equipped with a light, camera, and an electrified wire loop or cutting tool. Its camera transmits images to a monitor, allowing the surgeon to visualize the bladder lining and identify tumors.
The surgeon uses the wire loop to cut away the tumor in pieces, along with surrounding bladder wall tissue, including muscle if needed. After resection, the surgeon cauterizes the area with the electrified loop or a probe, sealing blood vessels to control bleeding. All removed tissue samples are sent to a pathology laboratory for examination, determining the tumor’s type, grade, and stage.
Recovery and Next Steps After TURBT
After TURBT, patients move to a recovery area as anesthesia wears off. Hospital stays vary; many patients go home the same day, while others stay overnight or longer, especially after extensive resection. Common side effects include a burning sensation during urination, increased frequency, and blood in the urine, which may persist for days to weeks.
Patients are encouraged to drink plenty of clear fluids to aid recovery and flush the bladder. A temporary urinary catheter may be inserted after the procedure to drain urine and prevent blood clots, typically removed before discharge. Pain management is provided, and patients should avoid strenuous activities and heavy lifting for two to four weeks to allow the bladder to heal, returning to normal activities gradually. Complications include urinary tract infections, heavy bleeding, or, rarely, bladder perforation.
Pathology results are available within two to three weeks and are discussed with a multidisciplinary team. These results detail the tumor’s type, grade (how abnormal cells appear), and stage (how deeply it has grown into the bladder wall). This information guides subsequent treatment decisions, which may include surveillance cystoscopies to monitor for recurrence, or intravesical therapy where medication is delivered directly into the bladder. In some cases, a second TURBT may be recommended within weeks, especially for high-risk non-muscle invasive bladder cancer, to ensure all cancerous tissue is removed and to confirm staging.