TURBT: Transurethral Resection of Bladder Tumor

What is transurethral resection of bladder tumor (TURBT)?

Transurethral resection of bladder tumor (TURBT) is a procedure that healthcare providers use to diagnose and treat bladder cancer at the same time.

During TURBT, a provider uses a long, thin tool with a camera on it (cystoscope) to find the tumor in your bladder and cut it out (resect it). Your provider sends the tumor to a lab where a pathologist will examine it. This helps determine its stage (how far it’s grown into your bladder wall) and grade (how different the cells look from normal cells).

Your provider doesn’t need to make any incisions for TURBT — the scope goes through your urethra (the tube that your pee travels through to get out of your body) to reach your bladder.

Why is TURBT done?

Providers perform TURBT when you have a tumor in your bladder that they need to biopsy and/or remove. It allows your provider to use just a single procedure to both remove and biopsy (take tissue samples from) the tumor.

How do you prepare for a TURBT?

Your provider will give you instructions on how to prepare for bladder tumor resection. Following their directions closely can reduce your risk of complications. Before TURBT, your provider may ask you to:

• Not eat anything for eight hours before the procedure (fast).
• Stop taking medications before the procedure or take them with just a sip of water. Don’t stop taking medications unless your provider tells you to.
• Arrange for someone to drive you home after the procedure.
• Take a bath or shower before you go in for the procedure. Don’t use any kind of lotions, perfumes or deodorants that day.

Tell your provider about all the medications you take, including over-the-counter (OTC) or herbal supplements. Dress comfortably the day of the procedure — you’ll have to change into a gown before it starts.

What happens during a TURBT procedure?

Just before a TURBT procedure, your provider may give you general anesthesia, which means you’ll be asleep. Some providers use regional (or spinal) anesthesia instead. This means you’ll be awake, but the lower half of your body will be numb.

In some cases, your provider might use a catheter to release a special dye into your bladder so they can see the tumor better. This will happen in the preoperative area, about an hour before the surgery. During the procedure, they’ll use a special light that illuminates the dye so they can see the tumor.

To perform TURBT, your surgeon will:

1. Insert the scope into your bladder through your urethra.
2. Locate and remove the tumor with a small cutting device. A pathology lab will examine it after the procedure.
3. Apply heat to stop any bleeding from where they resected the tumor.
4. Remove the scope and insert a catheter (if needed). This drains your pee and other fluids from your bladder and prevents blood clots. Your provider may also use the catheter to flush your bladder with saline (a sterile salt solution). Some people don’t need a catheter.

How painful is TURBT?

You shouldn’t experience pain during a TURBT procedure. After the procedure, you might have pain or discomfort, especially while peeing, for a week or two.

Do you need chemo after TURBT?

Some people might need chemotherapy after TURBT. Your provider might recommend intravesical chemotherapy — medicine delivered directly to your bladder through a catheter — after TURBT if the tumor hasn’t spread outside of your bladder. They might give you the first dose during the TURBT procedure by applying chemotherapy to the inside of your bladder after removing the tumor. Additional treatments would then start in the weeks following TURBT.

If cancer has spread (metastasized), you might have chemotherapy through an IV, so it can treat your entire body.

Do you stay in the hospital after TURBT?

After TURBT, providers will monitor you for a few hours at the hospital. If you have a catheter, sometimes they’ll remove it before you go home. Other times, the catheter stays in for a few days after you go home, depending on how big the tumor was and how bloody your pee is. After you go home, you:

• Should drink plenty of fluids as recommended by your provider.
• Can otherwise eat and drink as you normally would.
• Will have a follow-up appointment or be contacted by your provider with the biopsy results. Ask your provider when to expect results and how you’ll receive them.

What are the advantages of TURBT?

The main advantage of TURBT is that it can both biopsy and treat tumors that haven’t spread outside of your bladder. This reduces the number of procedures you need to undergo and the risks that come with them.

What are the risks and complications of TURBT?

Bladder tumor biopsy and resection is a very safe procedure. But, like any surgery, it has some risks. These include:

• Anesthesia-related risks (including allergic reactions and breathing problems).
• Urinary tract infections (UTIs).
• Excessive bleeding or bleeding that lasts a long time.
• Bladder injuries.

How long does it take to recover from TURBT?

It can take up to six weeks to feel like you’re fully recovered from a TURBT procedure. In the first week or two, you:

• Should get plenty of rest.
• Might have pain or burning when you pee. Your provider can let you know how to manage any discomfort.
• Might notice a little bit of blood in your pee. This is normal, but let your provider know if you see more blood than expected.
• Should avoid straining or lifting heavy objects. Your provider may also recommend you avoid driving.

Your provider will let you know when you can expect to return to your normal level of activity. They usually recommend waiting at least two weeks before gradually starting to get back to your typical activities.

Second-look TURBT

You might need a second TURBT procedure (also called a second-look TURBT) to reduce your risk of cancer spreading outside your bladder, and to make sure that all the tumor was removed during the first TURBT. This usually happens four to six weeks after the first procedure.

When should I call my healthcare provider?

Contact your provider if you have any questions before or after your procedure. Let them know right away if you have:

• Fever.
• Bloody, cloudy or foul-smelling pee.
• Unexpected or severe pain.
• Excessive amount of blood in your pee.
• Large blood clots in your pee.

What is the difference between a cystoscopy and a TURBT?

Cystoscopy is a procedure that allows a provider to look inside your bladder and urethra. It’s a broader procedure than TURBT that can be used for many different conditions. Providers use TURBT specifically to biopsy and remove bladder cancer.