Resection of Tumour
What is a transurethral resection of a bladder tumour (TURBT)?
A TURBT is the standard treatment for bladder tumours. The tumour or tumours are cut away from the bladder wall and sent for further analysis that will enable your Urologist to see whether the tumour cells are cancerous and if more treatment is needed.
What do I need to do before a TURBT?
You should take your normal medication as before the procedure. If you are on aspirin or clopidogrel (Plavix), these drugs will need to be stopped 10days before the operation. In addition, if you are on warfarin, this will need to be stopped and the appropriate alternative will be suggested. So ensure this is discussed with your urologist.
It is important to exclude a urinary tract infection before your procedure. The urine should be checked by a health professional.
No food should be eaten 6-8 hours before but a small quantity of clear water only can be consumed 3 hours before the planned time of laser prostatectomy.
What happens during a TURBT?
Under general anaesthesia (i.e. asleep), a telescope examination is made of the bladder using a camera mounted on the end of a tube passed through the water pipe (urethra). TURBT involves resecting the tumour using an electrical loop inserted into the urethra via a telescope. It cuts tissue and seals blood vessels as it removes the tumour. These are washed out at the end of the operation and sent for histological analysis. The procedure usually lasts between 30-60minutes and involves no incisions on the outside. A catheter is inserted for maximum 24 hours, through which irrigation fluid flows into the bladder to rinse any blood in it.
At the end of the operation, a catheter (drainage tube) may be placed into the bladder through the urethra. A water solution may be used to flush the bladder to wash out any blood in which case you may remain in hospital for a day or two. The doctor may prescribe Mitomycin C chemotherapy drug to be placed in the bladder soon afterwards the operation while you are still asleep in order to decrease the chance of the tumour coming back. Discharge usually occurs after 24 hours after the operation. In some cases, the patient may be discharged on the day of surgery. Most patients should be able to resume usual activities and return to work within the next few weeks.
The raw area in the bladder lining remaining after such a scraping will heal over, initially with a scab and, eventually, with normal lining tissue. It is not unusual to have increased frequency and urgency of urination for a few weeks after bladder tumour resection. There may also be some burning with urination. There may be a bit of blood visible in the urine for a few weeks after bladder tumour resection. Occasionally, a few blood clots may be seen, particularly after about two to four weeks when the scab comes away.
Most bladder tumours are confined to the bladder lining and are described as superficial. Even these superficial tumours however have a tendency to recur. It is important to monitor the bladder closely with regular bladder inspections (surveillance cystoscopy).