Patient education: Transurethral resection of a bladder tumor (The Basics)

What is transurethral resection of a bladder tumor? — Transurethral resection of a bladder tumor ("TURBT") is surgery to remove a tumor from the inside wall of the bladder. "Transurethral" means that it is done through the urethra. This is the tube that carries urine from the bladder to outside of the body (figure 1).

To do a TURBT, the doctor uses a "cystoscope" (a thin tube with a tiny camera on the end) to look inside the bladder. They put the cystoscope into the urethra and move it up into the bladder (figure 2). Then, they use the scope to remove the tumor. The doctor can also take a sample of tissue (called a biopsy) to look at under a microscope.

TURBT does not involve any incisions (cuts) on the outside of the body.

How do I prepare for TURBT? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Urine test

●Ultrasound – This is an imaging test. It uses sound waves to create pictures of the prostate.

●Special tests to check your bladder function

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during TURBT? — When it is time for the procedure:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will put the scope into your urethra. Then, they will use special tools to destroy or remove the tumor in your bladder.

●The doctor will remove the scope. They might place a catheter into your bladder to drain your urine temporarily.

What happens after TURBT? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Most people are able to go home the same day.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

●You might have a catheter in your bladder to drain urine. It is common for your urine to have a small amount of blood or blood clots in it. The doctor will remove the catheter in 1 to 14 days.

•Sometimes, after surgery, the doctor connects the catheter to fluids to help flush out your bladder.

•You might feel the need to urinate while the catheter is in place.

•If you go home with a catheter in, you will get instructions on how to care for it and when to have it removed.

•You might have some pain or burning when you urinate after the catheter is removed.

What are the risks of TURBT? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection (most often urinary tract infection)

●Problem with urine control, which is rarely long-lasting

●Injury to the urethra, causing scar tissue

●Bleeding or small blood clots in your urine

●A hole in the bladder

What else should I know? — If you are waiting for biopsy results, your doctor will tell you when you expect them. They might want to do another TURBT in a few weeks.

Before you go home after surgery, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

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