Transurethral resection of a bladder tumour (TURBT)

What is transurethral resection of a bladder tumour?

This is a procedure to establish the type of bladder tumour present, and potentially diagnose bladder cancer.  

A bladder tumour is a growth that starts in the lining of your bladder. Bladder tumours can bleed, causing blood in your urine. Sometimes blood clots can form, which may stop your bladder from emptying. You may have a burning sensation when you pass urine or you may need to pass urine more frequently.

Bladder tumours are either:

• Non-invasive tumours - which tend to stay in the lining of your bladder. This type of tumour isn’t a cancer, but could change into a cancer
• Invasive tumours - which are cancers that grow into and through the bladder wall. The cancer can spread to other parts of your body.

Your surgeon will remove tissues, and examine them under a microscope to find out the type of tumour you have. Your surgeon can also perform biopsies (removing small pieces of tissue) on areas of the bladder that appear normal, but are more likely to form tumours.

What are the benefits of transurethral resection of a bladder tumour?

Your symptoms should improve. Resecting (scraping away) a superficial bladder tumour should remove it completely and reduce the risk of you developing an invasive cancer.

If you have invasive cancer, a TURBT will not remove the cancer completely. However, examining the tissue under a microscope will help your surgeon to recommend the best treatment for you.

Are there any alternatives to TURBT?

Resecting the tumour is the only dependable way to find out the type of tumour you have. If you don’t have the operation and the tumour is superficial, there is a risk that it will change into a cancer.

If the tumour is a cancer, there is a risk that the tumour will grow deeper into the tissues of your bladder and the cancer may spread to other parts of your body.

What happens during the operation?

Resecting a bladder tumour is performed under a general or spinal anaesthetic. Your anaesthetist will discuss the options with you and will recommend the best form of anaesthesia for you. The operation usually takes less than 30 minutes.

Your surgeon will pass a resectoscope (a small operating telescope) into your bladder through your urethra (the tube that carries urine from the bladder). Your surgeon will use the resectoscope to identify and resect any tumours. They will seal the raw areas with an electric current (cauterisation). Your surgeon will sometimes use the resectoscope to perform biopsies.

At the end of the operation, your surgeon will remove the resectoscope and will usually place a catheter (tube) in your bladder. This will allow you to pass urine easily and for your bladder to be washed out with fluid to prevent blood clots.

Your surgeon may also recommend a single dose of chemotherapy given directly into your bladder through a catheter to reduce the risk of new growths forming in the lining of your bladder.

For more information, and if you have any queries about the procedure, speak to your consultant.

Continue taking your normal medication unless your surgeon tells you otherwise.

The following lifestyle changes can help make the procedure a success:

• Giving up smoking
• Eating healthily. If overweight, you have a greater chance of developing complications
• Exercising regularly. Your GP can recommend exercises.

Possible complications

• Some pain is common with most operations
• Bleeding after surgery
• Infection, which may need treatment with antibiotics
• Making a hole in the bladder. The risk increases if your surgeon needs to scrape into the wall of the bladder to remove a tumour. It usually takes a few days for the hole to heal, if the catheter is draining well. If the hole does not heal, you may need surgery
• Narrowing of the urethra, caused by scar tissue forming. If this happens, you may need further surgery.

This is not a definitive list and symptoms will vary with each patient. Please ask your consultant for more information.

What is involved in the recovery?

The catheter will usually be removed after one to two days. You should be able to go home after the catheter has been removed and you have passed urine. However, your doctor may recommend that you stay a little longer. Remember, you won’t be able to drive after the operation.

You may experience a little stinging the first few times you pass urine. Drink plenty of water, as this will help you to pass urine more easily and will reduce the risk of developing blood clots. You should be able to go back to work after about two weeks. It is normal to get blood in your urine every now and then while any raw areas in your bladder heal. If your bladder gets full and painful, tell your GP. You may need to come back to the hospital to have a blood clot removed using a catheter. Regular exercise should help your recovery – ask your GP for advice.

You will need to come back to the clinic for results from the examination of the tissue that your surgeon removed a few days later.

For further information, speak to your consultant.

Paying for your operation

TURBT (transurethral resection of a bladder tumour) costs are covered by most medical insurance policies, but please check with your insurer first. If you are paying for your own treatment the cost of the operation will be explained and confirmed in writing when you book the operation. Ask the hospital for a quote beforehand, and ensure that this includes the surgeon’s fee, the anaesthetist’s fee and the hospital charge for your procedure.