Transurethral Resection Of Bladder Tumour (TURBT)

What is a TURBT?

Transurethral Resection Of Bladder Tumour It means that the growth in your bladder will be removed Endoscopically.The bladder is a muscular, hollow, balloon type organ situated in the lower abdomen. Urine travels from the kidneys to the bladder via tubes called ureters. When the bladder is full the urine passes out of the body through a tube called the urethra. The urethra opens at the tip of the penis in men.

How is a TURBT performed?

The operation is performed under general or local anaesthesia. The operation is performed through a telescope passed along the water pipe (urethra) with no external cuts or scars. An electrical loop is used to cut away small parts of the tumour, until it has been completely removed. The pieces of the bladder tumour are sent away to the lab for examination.

At the end of the operation, a catheter is left in the bladder, which drains the urine and helps to wash away any blood. This catheter stays in for 24-48 hours.

What type of anaesthetic will I have?

The anaesthetist before the operation to discuss the alternatives will visit you. The anaesthetist will also check that you are fit enough for the anaesthetic. A TURBT is usually done with a general anaesthetic (asleep) or a spinal anaesthetic (an injection in the back to make you numb from the waist down).

Getting ready for the operation

If you smoke, try and cut down or preferably stop, as this reduces the risks of heart and chest complications during and after the operation. If you do not exercise regularly, try and do so for at least half an hour per day e.g. brisk walk or swimming.

You will be sent an appointment to visit the pre-assessment clinic a few days before your operation date. This is a general health check to ensure you are fit for surgery. The pre-assessment nurse will organise for you to have bloods taken and have an ECG (heart tracing), and answer any questions that you may have.

What are the risks, consequences and alternatives associated with having a TURBT?

Most procedures are straightforward; however as with any surgical procedure there is a chance of side effects or complications.

Common

Temporary mild burning, bleeding or frequency of urination after the procedure

Need for additional treatments to bladder in attempt to prevent recurrence of tumours, including drugs instilled into bladder

Occasional

Urine infection requiring antibiotics

No guarantee of cancer cure by this operation alone

Recurrence of bladder tumour and / or incomplete removal

Rare

Delayed bleeding requiring removal of clots or further surgery

Damage to drainage tubes from kidneys (ureters) requiring additional therapy

Injury to urethra causing delayed scar formation

Perforation of the bladder requiring temporary insertion of a catheter or open surgical repair

Alternatives to TURBT

  • Open surgical removal of bladder
  • Chemotherapy
  • Radiotherapy

What should I expect after the operation?

After your operation you will normally go back to the urology ward. You can start eating and drinking as soon as you recover from the anaesthetic.

We often give a bladder treatment after this kind of operation. A drug (called mitomycin-C) is flushed into the bladder through the catheter to reduce the risk of further tumours growing in the future.

Pain

Because there are no external cuts, this procedure is relatively pain free. You may experience some discomfort from the catheter, but this is usually easily treated with mild painkillers (eg paracetamol).

Catheter

A urinary catheter is a tube that runs from the bladder out through the tip of the penis and drains into a bag. It is important to drain the urine in this way until the urine as clear. Your catheter is usually removed 24-48 hours after your operation.

Once the catheter has been removed, and you are passing water normally, you will be able to go home.

Discharge information and home advice

Bleeding

It is quite normal to see an occasional show of blood after discharge. This is due to the healing of the operation site. If you see blood, simply increase your fluid intake. If you have prolonged bleeding or increasing difficulty passing water, please contact the hospital.

Pain

Mild painkillers such as Paracetamol should be enough to deal with any pain.

Exercise

You should take it easy for a month, although it is important to take some gentle exercise like walking, as you will be at a slight risk of developing a blood clot in your legs. During the first 4 weeks you should not:

Lift or move heavy objects

Carry shopping

Work

Recovery takes 6-8 weeks from your operation date. Your doctor will be able to advise you when it will be safe to return to work as this depends on your occupation. The nurse can provide a sick note for your hospital stay.

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