Transurethral Resection of the Bladder Tumour (TURBT) is a common bladder cancer surgery used to treat early-stage bladder cancer. This minimally invasive procedure assists for bladder tumour removal while preserving bladder function. As an essential step in bladder cancer treatment, TURBT helps determine the stage and grade of the tumour, guiding further care if needed. Understanding the procedure, recovery, and potential risks can help patients feel more prepared and informed about their treatment options.
Transurethral Resection of Bladder Tumour (TURBT)
What is a TURBT?
After the diagnosis of a bladder tumour, the urologist will suggest that the patient undergo an outpatient surgical procedure in the hospital to remove the as much of the tumour as possible from the bladder. This procedure is called a transurethral resection of a bladder tumour (TURBT). This bladder tumour removal surgery allows the doctor to examine the bladder more completely under anaesthesia (general or spinal). To see inside the bladder, they use a resectoscope. Like the cystoscope, the resectoscope is introduced through the urethra into the bladder.
The resectoscope has a small, electrified wire loop at the end that can remove the tumour. This loop also cauterizes or seals off blood vessels to help stop bleeding, a process known as “electrocauterization” or “fulguration.” The advantage of the TURBT is its repeatability with minimal risk and excellent results. The risk of infection or bladder injury is less than 10%, and both are easily correctible.
The TURBT procedure typically lasts no longer than one hour. Patients are placed under anesthesia to ensure they are in a deep sleep during the surgery and do not feel any discomfort.
What are the Risks and Benefits of TURBT Bladder Cancer Surgery?
Like any surgery, a TURBT carries both risks and benefits. Generally, this bladder tumour removal procedure is considered very safe. However, there are potential risks during or after surgery, including:
- Anesthesia-related complications
- Urinary tract infections
- Bleeding after surgery
- Perforation of the bladder
Despite these risks, TURBT procedures are often successful in treating early-stage bladder cancer. They can help prevent the cancer from spreading into the muscle wall of the bladder.
How to Prepare for a TURBT Procedure?
Your physician will provide specific instructions, but generally, it is advised to stop taking aspirin, ibuprofen, naproxen, or blood thinners for one week before surgery, as these medications can increase the risk of bleeding.
One to two weeks before surgery, you may have a pre-op appointment or consultation to ensure anesthesia is suitable for you. Your physician may also request a urine culture before surgery to check for any infections or complications that could affect the TURBT procedure.
You will need to fast, abstaining from eating or drinking anything, including water, after midnight the night before your TURBT procedure, unless you are advised otherwise. It is crucial to follow these guidelines to prepare for the bladder tumour removal surgery.
Additionally, you will require a friend or family member to drive you home after the TURBT procedure if you are not staying overnight in the hospital.
What Happens After the TURBT?
After TURBT surgery, all tumour samples are sent to a pathologist for examination. The pathologist will confirm the bladder cancer type and its depth of invasion into the bladder wall, if any. These details help determine the cancer’s stage and grade, along with imaging results like CT scans. This information guides your medical team in determining the type and duration of any further necessary treatment.
What are the Side Effects of a TURBT Surgery?
Common side effects of TURBT include bleeding, pain, and burning during urination. These effects can be intermittent and may last for up to a month. In cases where the bladder tumour is large, a catheter may be left in the patient’s bladder for a day or two to reduce the risk of issues such as bleeding, clot formation, or bladder expansion due to urine or blood accumulation. Even for small tumours, a catheter may be used to flush the bladder if bleeding continues after the bladder tumour removal.
Recovering From a TURBT Bladder Cancer Surgery
Following a transurethral resection of a bladder tumour (TURBT), your recovery may involve staying at home or spending a few days in the hospital. The initial 5-7 days post-TURBT surgery are critical for healing, during which you should rest and avoid strenuous activities. This rest period is essential for bladder healing and reducing the risk of bleeding. Recovery time varies from person to person.
You may need a catheter inserted into your urethra to prevent blockage, which is typically removed once the bleeding stops. It is normal to experience frequent urination, burning, or stinging when urinating after surgery. These symptoms should improve over time. Staying hydrated by drinking fluids can aid in the healing process. Pink urine is common due to blood, but if these symptoms persist for more than a few weeks, consult your doctor.
Avoid strenuous activities and heavy lifting for about three weeks after TURBT surgery. This includes lifting grocery bags, children, pets, or anything else that causes strain. Follow your doctor’s advice and consult your medical team for any additional recommendations related to TURBT recovery.
When to Contact Your Doctor After a TURBT Procedure
If you experience any of the following symptoms after your TURBT procedure, it is important to contact your physician’s office immediately:
- Inability to urinate
- Passing blood clots in your urine that are the size of a quarter or larger
- Fever above 38°C and/or chills
- Nausea and vomiting
Always follow your physician’s recommendations as with any bladder cancer surgery or medical procedure.
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