surgery

What is involved in the surgery procedure?

The majority of bladder cancer are treated with TURBT alone

The majority of bladder cancers at the time of diagnosis are low-grade and non-invasive.


surgery main points

Key Points:

Hematuria (blood in urine) is frequently attributed to bladder tumors.

  • Resection of bladder tumors involves using a telescope inserted through the urethra to shave them off the bladder wall.

  • Extracted tissue fragments undergo pathology analysis to determine the tumuor's cancerous nature and assess the depth of invasion into the bladder wall.

  • Some patients may require additional treatment, such as chemotherapy, radiotherapy, or surgery.

  • Regular follow-up with telescopic bladder examinations is advisable for most patients.

surgery

What occurs on the day of the procedure?

A/Prof Homi Zargar will discuss the surgery once again to ensure your understanding and obtain your consent. An anaesthetist will meet with you to explore the options of a general or spinal anaesthetic and discuss post-procedure pain relief.

Details of the procedure:

  • Depending on individual circumstances, the procedure is typically conducted under either general or local anaesthesia.

  • Before the procedure, antibiotics are administered after confirming the absence of allergies.

  • A telescope is inserted through the urethra into the bladder to identify the tumour.

  • Using diathermy or laser energy, the tumour is resected (shaved) off the bladder wall, piece by piece.

  • Bleeding is stopped by cauterizing the tumour base with diathermy or a laser.

  • Tumour fragments are removed from the bladder and sent for pathology analysis.

  • A bladder catheter is usually placed through the urethra with irrigation to prevent blood clot formation.

  • Sometimes, Mitomycin C, an anti-cancer drug, is instilled into the bladder immediately after the procedure.

  • The drug is left in the bladder for one hour and then drained away, often in the theatre recovery area.

  • The procedure's duration ranges from 15 to 90 minutes, depending on tumor size and number.

  • Most patients can go home on the same day, but occasionally, an overnight hospital stay may be required.

After-Effects and Risks of the Procedure:

  • Mild burning with blood in urine for a short time after the procedure (Almost all patients).

  • Need for additional treatment to prevent later tumor recurrence (e.g., Mitomycin C instillation) (Almost all patients).

  • Infection in the bladder requiring antibiotic treatment (Between 1 in 10 & 1 in 50 patients).

  • Recurrence of the tumor and/or incomplete removal (Between 1 in 10 & 1 in 50 patients).

  • Delayed or ongoing bleeding requiring further surgery to remove blood clots (Between 1 in 50 & 1 in 250 patients).

  • Damage to the ureters (tubes that drain urine from your kidneys to your bladder) requiring further treatment (Between 1 in 50 & 1 in 250 patients).

  • Injury to the urethra resulting in delayed scar formation and a urethral stricture (Between 1 in 50 & 1 in 250 patients).

  • Perforation of your bladder requiring a temporary bladder catheter or open surgical repair (Between 1 in 50 & 1 in 250 patients).

  • Anaesthetic or cardiovascular problems possibly requiring intensive care (including chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack, and death) (Between 1 in 50 & 1 in 250 patients; your anaesthetist can estimate your individual risk).