Transurethral Resection of Bladder Tumour (TURBT)

TURBT surgery
Tumour typical of bladder cancer

Transurethral resection of bladder tumour (TURBT) is the endoscopic removal of tumours in the bladder. A resectoscope (a loop-cutting instrument) is passed through the urethra to cut the whole tumour down to its base. Biopsies are then taken from the base to see if it has invaded into the bladder muscle. Random biopsies are also taken from the rest of the bladder to exclude pre-cancerous areas (CIS). Accurate sampling is important as the subsequent treatment depends on the staging.The operation takes up to 1 hour. General or spinal anaesthesia is given and hospital stay is 3 to 4 days. A catheter is inserted into the bladder after the surgery for irrigation and to prevent blood clots from forming. Additional chemotherapy e.g. mitomycin C is also instilled within 24 hours of the surgery to reduce any recurrence. As the bleeding can be excessive, any blood-thinning medication, such as aspirin or Plavix must be stopped 1 week beforehand.

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Complications include:

  • excess bleeding. Even after the catheter is removed, bloody urine can be expected to last up to 2 weeks.
  • perforation of the bladder during resection. If this happens, urine can leak out of the bladder. If the perforation communicates with the abdomen cavity, emergency surgery to repair the bladder is needed.

Desired outcomes:

  • no blood transfusion ( < 3% chance )
  • no bladder perforation ( < 1% risk )
  • no recurrences