Transurethral Resection of Bladder Tumor (TURBT)

Updated: Dec 5, 2022

What is transurethral resection of bladder tumor?

Transurethral resection of bladder tumor (TURBT) is a procedure in which your doctor removes a tumor or a growth from your bladder with a small instrument called a resectoscope. The resectoscope is inserted through your urethra as shown in Figure 1.

A TURBT is usually performed in a surgery center or in a hospital under general or spinal anesthesia. This is done so that you will not feel pain or discomfort during the procedure. The procedure usually takes about a half hour or longer, depending on the size of the tumor.

The possible risks or complications associated with a TURBT include but are not limited to bleeding, infection, burning upon urination, and perforation of the bladder (having a hole in the bladder). Bladder perforation is rare. However, if this occurs, additional treatment or surgery may be required to fixed the perforation.

The benefits of a TURBT include the removal of the tumor and the examination of the pieces of tumor by a pathologist (a doctor who examines tissue) to determine whether the growth is cancerous (i.e. a malignant tumor) or noncancerous (i.e. a benign tumor). The results from the pathologist will also indicate how deep the tumor has grown into the bladder wall. It usually takes several working days to get the results from a pathologist.

The alternatives to a TURBT include but are not limited to having the tumor destroyed or burned by electricity or a laser. There is also the option of not having a TURBT.
However, please be aware that the tumor may get larger and spread. If the tumor is destroyed or burned without retrieving pieces of the tumor first, the pathologist will not be able to determine how deep into the bladder wall the tumor has grown or whether the tumor is cancerous.

The likelihood of success or the chance that your doctor can successfully remove the tumor is usually dependent on the size and location of the tumor. For very large tumors, your doctor may have to do a repeat TURBT or may opt to perform a different surgery or treatment.

You should let your doctor know all the medications that you are taking, including over the counter medications. If you take blood thinning medications such as plavix, warfarin, aspirin, ibuprofen, or naproxen, ask your doctor how many days before the procedure you should stop these medications.
Let your doctor know if you are allergic to anything including medication, tape, or latex.
Also, inform your physician if you are currently having a bladder infection (symptoms include burning upon urination or frequent urination).
Finally, let your doctor know if you are or suspect you are pregnant.
You should not eat or drink anything after midnight or at least 8 hours prior to the procedure. Usually you may take your regular medication with a few teaspoons of water.
You will need to arrange for someone to drive you home from the hospital as you can not operate heavy machinery for at least 24 hours after you were administered anesthesia. Be sure to dress comfortably for the procedure.

Figure/Video 1 : A video clip of a bladder tumor being scraped off by a resectoscope

A soft, hollow tube called a Foley catheter will be inserted into your bladder to drain your urine (Figure 2). You will be sent to the recovery room for about 1-2 hours. You may be discharged from the hospital with a Foley catheter and leg bag (Figure 3), which can be applied to your thigh and hidden beneath your dress or pants.

When the tumor is large and there is continuous bleeding after a TURBT procedure, the doctor may keep the patient in the hospital and put the patient on what is called "continuous bladder irrigation". The patient's bladder will be irrigated continuously with salt water to clear out the blood.
The doctor may also put some chemotherapy medication (medication that treats the cancer) into the bladder after the removal of the tumor. The chemotherapy medication is usually held in the bladder for about 1 hour and drained out in the recovery room.

You should make sure to...

Follow the instructions given by the nurse in the hospital.
It is okay and relatively normal to see brownish or reddish urine with some small blood clots.
Occassionally, you may also feel the urge to urinate and see some urine leak out around the catheter. These are usually called "bladder spasms".
You should drink plenty of water so that there will be more urine flow to keep the urine clearer.
For about 3 weeks, you should not perform any heavy lifting or straining.
You should avoid constipation by taking a stool softener or laxative given by your doctor and eating more fruits and vegetables.
You may also take showers with the catheter inside the urethra. Additionally, make sure to wash the catheter daily.
Make sure to ask your doctor when you are able to set up a follow up visit, drive, and return to work.

Have a fever with a temperature of over 100.4 degrees Fahrenheit or shaking chills. This may be an indication of infection.