TURBT – Transurethral Resection of Bladder Tumour

TURBT is a procedure performed to remove bladder growths. Most bladder tumours are confined to the superficial layer of the bladder and can be completely removed telescopically. Deeper and more aggressive tumours may require complete bladder removal by open surgery.

Procedure

TURBT is performed in the operating theatre under a general or spinal anaesthetic. A narrow telescope is inserted through the urethra into the bladder then the bladder tumour is shaved away using an electrocautery instrument (resectoscope). TURBT takes 30-60 minutes to perform. If the tumour is large or there are multiple tumours then a catheter may be left in your bladder overnight. For large or recurrent tumours we may leave a drug in the bladder (epirubicin) for one hour post-operatively. This reduces the risk of tumour recurrence.

Pre-Procedure

Aspirin, clopidogrel, dabigatran, warfarin and any other blood thinning medications will need to be stopped prior to surgery. We will advise you on the timing of when to stop and re-start these medications.

A urine sample needs to be provided to the laboratory 1 week prior to surgery.

Post-Procedure

Following TURBT you will be taken to the recovery room & usually spend 30 minutes there before returning to the ward. Once you are comfortable and passing urine then you can head home. If a catheter has been placed then you may stay overnight. There will be blood in your urine for at least two weeks and you will experience stinging with urination initially. This resolves within four weeks as the bladder heals.

Risks

Following TURBT it is possible, although unlikely, that you may have ongoing bleeding which may require a longer period of catheterization or catheter re-insertion. Rarely the bladder may need to be re-inspected under anaesthetic in order to control the bleeding. Perforation of the bladder during surgery is uncommon. If perforation occurs then a longer period of catheterization is usually all that is required to heal the hole. Very rarely surgical repair may be required. Other risks may include urinary infection, blood clots, chest infection.

Return to Work

You can plan to return to a sedentary job within five days. Heavy lifting & straining needs to be avoided for six weeks as this can cause bleeding from the bladder.

Follow-up after surgery

The pathology report takes two weeks to be produced. I will contact you when this is available. Bladder tumours commonly recur so ongoing surveillance with regular cystoscopy and periodic imaging of the kidneys and ureters with CT scan is required.

Other Risks

Risks recognised as common or serious are listed below but this does not include the rare and extraordinary.

  • Urinary infection

  • Bleeding

  • Failure to void after catheter removal

  • Bladder perforation

  • Blood clots in your lower leg, which could pass to your lungs - This includes leg swelling, leg pain, chest pain, or shortness of breath. Blood clots after surgery are rare but dangerous and need urgent treatment. If you experience any of these symptoms then you need urgent medical review.