What is TURBT?
Transurethral Resection of Bladder Tumour (TURBT) is the minimally invasive procedure performed for the diagnosis and management of early-stage tumours of the urinary bladder. In the majority of the patients, with bladder cancer, cancer does spread to the muscular wall of the bladder at the time of diagnosis. TURBT is the standard method used in such patients. Men are at four times more risk of developing the bladder tumour than women. The TURBT procedure can involve both biopsy and resection. During a biopsy, the doctor obtains a tissue sample from the bladder and sends it to the laboratory to determine the presence and staging of cancer. During the biopsy procedure, the surgeon also simultaneously removes any cancerous growth which is known as resection.
Who needs TURBT?
- The doctor performs TURBT to diagnose, stage and remove the early-stage tumour of the urinary bladder.
- It is a standard treatment for urothelial carcinoma, accounting for approximately 90% of all urinary bladder cancer. Urothelial carcinoma is a type of non–muscle-invasive bladder cancer when the tumour is limited to the superficial layer of the bladder.
- Apart from staging and grading cancer, TURBT also helps relieve the symptoms of bladder cancer.
- The technique is effective in those cases of bladder cancer in which the cancer cells are visualised. However, TURBT is not usually done for carcinoma-in-situ or when cancer has spread to the muscle wall of the bladder. In such cases, the tumour is diffused and not clearly visualised, making the surgical removal of abnormal tissues almost impossible.
What to expect before surgery?
You may expect the following before the surgery:
- The doctor may advise a pre-anaesthetic check-up to determine your suitability for anaesthesia.
- The doctor may seek detailed information about the medical history and current medications you are taking.
- The doctor will analyse the results of the pre-anaesthesia check-up, and if found satisfactory, he may provide you with a date for surgery.
- The surgeon may also advise you to avoid taking medicines that increase your risk of bleeding, such as NSAIDs or warfarin.
- You may also be advised to avoid smoking immediately.
- You may be advised to stop eating and drinking for at least one night before the surgery. If you need to take medicines on the day of surgery, take them with just one to two sips of water.
- Your doctor will also explain to you the procedure, estimated cost, and recovery period so that you can plan your surgery in a better way.
What to expect on the day of surgery?
You may expect the following on the day of surgery:
- Always visit the hospital a few hours before the scheduled time of surgery to feel comfortable.
- Take a bath before visiting the hospital for surgery. However, avoid any type of make-up, cream, lotions, or deodorant on the day of surgery.
- Bring an ID while visiting the hospital for surgery but do not carry any jewellery or other valuable items to the hospital.
- The relative or friend accompanying you may complete the formalities, such as filling informed consent form or paying the surgery fee.
- The staff may advise you to remove the jewellery, contact lens, or dentures before surgery.
- You need to change your clothes and wear a hospital gown.
- The staff will evaluate and continuously monitor your vitals, such as blood pressure, heart rate and respiratory rate.
- You will then be shifted to the surgery room for TURBT.
What to expect during surgery?
You may expect the following before the surgery:
- The doctor will advise you to lie on the operation table on your back.
- The staff will insert an IV line through which anaesthesia and other drugs ate administered.
- You will be given either general or regional anaesthesia.
- The doctor will examine the bladder, urethra and prostate under anaesthesia.
- The staff will monitor the blood pressure, heart rate, oxygen levels, and respiratory rate before and during the procedure.
- The doctor will then perform the resection surgery.
What to expect after surgery?
You may expect the following after the surgery:
- After the procedure, the staff will attach a catheter to the bladder to drain the urine.
- The doctor may not remove the IV line if you require the administration of chemotherapy drugs.
- The staff will take you to the recovery room to recover from anaesthesia and monitor the vitals.
- The doctor will advise you to drink sufficient water to flush the bladder.
- You may feel a little pain or discomfort during urination.
- The patients, in most cases, are discharged on the same day of surgery. However, in some cases, patients need to stay for one day.
- During your discharge, the doctor will prescribe you medications, such as antibiotics and analgesics and give instructions about your recovery.
- Most people resume their normal activities within two weeks.
First follow-up appointment
- Do not miss any follow-up visits, especially when you are under treatment for life-threatening conditions, such as cancer.
- As the biopsy results may arrive within two weeks, the doctor may advise you for a follow-up visit at this time.
- You may undergo a detailed health check-up for any post-surgical complications during the follow-up visit.
- The doctor will further discuss the treatment strategy depending on the biopsy results.
- If required, you may undergo a second TURBT two to six weeks after the first TURBT.
- You may also ask about your concerns about the recovery and possible prognosis of bladder cancer during the follow-up visit.
What are Risks and Complications after TURBT?
TURBT is a minimally invasive surgery and has fewer complications. However, patients may experience complications with TURBT. Consult your doctor (do not wait for a follow-up visit date) if you experience the following symptoms:
- Pain and burning sensation during urination a few weeks after surgery
- Persistent blood in the urine
- Return of symptoms that were before surgery (this could be a sign of incomplete resection or tumour recurrence)
- Fever and chills