Transurethral resection of bladder tumour (TURBT) is one of the main surgical procedures used in the diagnosis and management of bladder cancer.
Key points
- Minimally invasive
- Requires general anaesthesia
- Approximately 1-hour operation
- 1-2 day hospital stay
Why choose Urocare?
At Urocare London, our commitment to excellence in urology is driven by the expertise and dedication of our leading specialist, Mr. Maneesh Ghei. Located at leading private hospitals in London, Urocare London offers the convenience and accessibility you need.
What is TURBT?
Transurethral Resection of Bladder Tumour (TURBT) is a pivotal surgical procedure primarily utilised in the diagnosis and management of bladder cancer. This minimally invasive technique involves scraping away tumours from the bladder lining using a specialised electric current, ensuring precision and minimising trauma to surrounding tissues.
Who is TURBT suitable for?
TURBT is particularly recommended for individuals diagnosed with tumours of the bladder.
Is TURBT a major operation?
While TURBT is considered a surgical procedure, it is minimally invasive and performed via the urethra, eliminating the need for external incisions. This approach significantly reduces the procedure’s invasiveness compared to traditional open surgery, offering a quicker recovery period and fewer complications.
How long does a TURBT procedure take?
A TURBT procedure takes approximately up to one hour.
What to expect at your TURBT procedure
- Pre-Procedure Preparation: Due to the use of general anaesthesia, a fasting period of 6 hours before the procedure is required.
- Anaesthesia: General anaesthesia is administered, ensuring you remain comfortable and pain-free throughout the procedure.
- Tumour Resection: The surgeon introduces a resectoscope through the urethra into the bladder. Visible tumours are then precisely shaved away from the bladder lining using a mild electrical current.
- Specimen Collection: The excised tumour tissues are collected and sent to a laboratory for detailed histopathological analysis.
- Post-Operative Care: A catheter is inserted to facilitate urine drainage and remove any blood and debris from the bladder. This catheter remains in place until the bleeding subsides, typically being removed before hospital discharge within 24-48 hours.
What happens after the procedure?
In the week following the TURBT procedure, it is common to experience:
- Blood in the urine
- Discomfort during urination
- Difficulty passing urine
These symptoms gradually subside as the bladder heals.
Relieving pain after TURBT
To alleviate discomfort post-TURBT, routine analgesics and anti-inflammatory medications are recommended. These medications effectively manage pain, ensuring a more comfortable recovery period.
What are the possible risks of TURBT?
Although TURBT is generally safe, as with any surgical procedure, there are potential risks, including:
- Infection
- Bleeding
- Pain
- Bladder injury
Your medical team will closely monitor you for any signs of these complications and provide appropriate care as needed.
Alternative treatments to TURBT
For certain patients, alternative or adjunctive treatments may be considered, including:
Intravesical Therapy
Intravesical therapy involves the direct instillation of chemotherapy or immunotherapy agents into the bladder through a catheter. This treatment is often used after TURBT to prevent the recurrence of non-muscle invasive bladder cancers.
Radical Cystectomy
For muscle-invasive bladder cancer or high-risk, non-muscle invasive cancer that does not respond to other treatments, radical cystectomy may be recommended. This surgery involves the removal of the entire bladder along with nearby lymph nodes, and possibly other organs that are involved, such as the prostate in men or the uterus and part of the vagina in women.
Combining Treatments
Often, a combination of these treatments is used to manage bladder cancer effectively, especially in advanced stages or for aggressive tumours. The choice of treatment or combination thereof depends on various factors, including the type and stage of cancer, previous treatments, and the patient’s overall health and preferences.
Frequently asked questions
How does a TURBT spot bladder cancer?
TURBT allows for direct visualisation of the bladder’s interior using a camera attached to a resectoscope, which is inserted through the urethra. This method enables the surgeon to identify and precisely remove tumours from the bladder lining, allowing for both the treatment of visible cancer and the collection of tissue samples for further pathological examination to confirm the presence and type of bladder cancer.
What preparation is required before undergoing a TURBT procedure?
Patients are typically advised to fast for at least 6 hours prior to the procedure due to the use of general anaesthesia. Additionally, any blood-thinning medications should be discussed with the healthcare provider, as they may need to be paused or adjusted before the surgery. Patients will also undergo pre-operative assessments to ensure they are fit for the procedure.
Can TURBT be used to treat all types of bladder cancer?
TURBT is most effective for diagnosing and removing non-muscle invasive bladder tumours. For muscle-invasive bladder cancer or more advanced stages, additional treatments such as radical cystectomy, chemotherapy, radiation therapy, or immunotherapy may be necessary. The suitability of TURBT depends on the cancer’s stage and grade, determined through initial diagnostic tests.
What can I expect during the recovery period after a TURBT procedure?
Post-TURBT, patients may experience blood in their urine, discomfort during urination, and a temporary difficulty in passing urine. These symptoms usually improve within a week. It’s essential to follow your doctor’s advice on pain management, hydration, and catheter care if applicable. Most patients can resume normal activities within a few days, but strenuous activity should be avoided for a couple of weeks.
For information on TURBT from the British Association of Urological Surgeons, click here.