transurethral resection of bladder tumour (TURBT)

What is involved in transurethral resection of bladder tumour (TURBT)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.


TURBT 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).