Drogosis Achillefs Urological Surgeon Athens Greece

BLADDER TUMOR RESECTION

The transurethral resection of a bladder tumor (TURBT) is an endoscopic procedure during which, via the urethra, bladder tumors are removed.

Transurethral resection of a bladder tumor (TURBT)

Indications

The transurethral resection of a bladder tumor is the procedure of choice for the diagnosis and treatment of superficial (non-invasive) tumors of the bladder.

Preparation

On admission to the hospital a pre-operative assessment is carried out which includes:

  • Urine tests
  • Blood tests
  • Chest X-ray
  • Cardiac assessment

In the event that a patient is on anticoagulant medication it is necessary to stop taking this, and instead to receive injections of low-molecular-weight heparin a few days prior to the surgical procedure.

How the transurethral resection of bladder tumor (TURBT) is performed

The procedure can be can be performed under general or epidural anesthesia.

The patient is placed in supine position with the feet supported in stirrups (as used in gynaecological examinations).

Following thorough antiseptic cleansing of the genital area, an endoscopic instrument is inserted through the urethra which allows the identification and removal of abnormal growths.

Using electricity and heat via the cystoscope the lesions on the bladder lining are shaved off.

Subsequently, the area is cauterized to stop any bleeding.

The abnormal growth tissue removed is sent to a pathology laboratory for histological examination.

On completion of the procedure, a catheter is put in place and flushing out of the bladder with saline solution commences.

The patient remains in hospital for a period of time which can vary depending on the size of tumor removed and which normally does not exceed three days.

After the procedure

In the days immediately following TURBT surgery there may be blood in the urine, which necessitates the continuation of flushing out of the bladder with saline solution.

At discharge you will receive instructions regarding:

  • The necessity of drinking plenty of fluids
  • Antibiotic medication which you need to take
  • Receiving the results of the histological examination
  • For how long you should avoid strenuous physical activity

Depending on the results of the histological examination, it may be necessary to repeat the procedure 2 to 6 weeks after the first surgery.

Post-procedure follow-up and treatment

This depends on histological examination results.

Superficial tumors

Regular cystoscopy will be needed and in some cases intravesical chemotherapy (where a medication is instilled into the bladder via catheter).

Invasive tumors

Depending on the general health of the patient the options might be:

a. Radical cystectomy and urinary diversion

b. A combination of transurethral resection, radiotherapy and chemotherapy

With every patient with abnormal growth in the bladder it is recommended that they quit smoking, as doing so is proven to reduce the probability of recurrence of the bladder cancer.