Banner Image: Dr. Surena Matin of MD Anderson Cancer Center performing a bladder cancer TURBT.
Generally, after the diagnosis of a bladder tumor, the urologist will suggest that the patient have an outpatient procedure in the hospital to examine the bladder more completely under anesthesia (general or spinal) and to remove, if possible, those tumors which are suitable for resection. The doctor may refer to this procedure as a TURBT (transurethral resection of a bladder tumor).
The bladder cancer TURBT is “incision-less” surgery usually performed as an outpatient procedure. It is the first-line surgical treatment for bladder tumors. Like the cystoscope, the resectoscope, the instrument used to remove the tumor in the TURBT, is introduced through the urethra into the bladder. Attached to this scope is a small, electrified loop of wire which is moved back and forth through the tumor to cut and remove the tissue. Newer technology known as “blue light” cystoscopy uses an optical imaging agent is often used during this procedure at major medical centers.
Electricity is also used to seal off bleeding vessels. This is sometimes called electrocauterization or fulguration. One of the advantages of this procedure is that it can be performed repeatedly with minimal risk to the patient and with excellent results. There is less than a 10% risk of infection or injury to the bladder, and both are easily correctable.
The most common risks of the TURBT are bleeding, pain, and burning when urinating and all three are temporary. If the bladder tumor is large, the urologist may choose to leave a catheter in the patient’s bladder for a day or two to minimize problems occurring from bleeding, clot formation in the bladder or expansion of the bladder due to possible storage of excess urine or blood. Even if the tumor is small, a catheter may be inserted to rinse the bladder out if the bleeding persists.
All the specimens from the TURBT will be sent to the pathologist for review. The pathologist will confirm the type of bladder cancer and the depth of invasion into the bladder wall, if any. These findings, along with results from imaging such as CT scans, will determine if further treatment is necessary.
Click here to read our Get the Facts | TURBT (PDF), filled with advice from patients who have experienced it.
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