Trans-Urethral Resection of Bladder Tumor (TURBT)

Overview

A TURBT is the removal of tumor from the bladder by going through the urethra which is the tube that carries urine from your bladder to the outside of your body.

Indications

The symptoms of bladder cancer can be very generalized. Pain with urination, blood in the urine and urinary frequency are some of the symptoms one might experience. In order to diagnose a bladder tumor the urologist will look inside the bladder with a cystoscope. Often, this is can done in the office as a surveillance procedure.

If an abnormal growth is found, it will need to be removed under general anesthesia. This procedure is done in a hospital or at an ambulatory surgery center.

Procedure

TURBT

There is no incision required for this procedure. The doctor will use a cystoscope to access the bladder through the opening of the penis. A device called a loop is used to peel the tumor away from the bladder wall and it is removed through the cystoscope. Below are some examples of bladder tumors that were removed during surgery.

Image on the left shows a papillary bladder tumor and the image to the right is the same bladder tumor post-resection and fulgeration.

Post-Op Instructions

Your recent bladder surgery requires very little post operative care but some definite precautions.

Despite the fact that no skin incisions were used, the area around the bladder cutting is raw and is covered with a scab to promote healing and prevent bleeding. Certain precautions are needed to insure that this scab is not disturbed over the next 2-4 weeks while the healing proceeds.

Because of the raw surface inside your bladder and the irritating effects of urine, you may expect frequency of urination and/or urgency (a stronger desire to urinate) and perhaps even getting up at night more often. This will usually resolve or improve slowly over the healing period you may see some blood in your urine over the first six weeks. Do not be alarmed even if the urine was clear for a while. Get off your feet and push fluids until clearing occurs. If you start to pass clots or don’t improve, call our office.

Diet

You may return to your normal diet immediately. Because of the raw surface inside your bladder, alcohol, spicy foods, acidy foods and drinks with caffeine may cause irritation or frequency and should be avoided. To keep your urine flowing freely and to avoid constipation, drink plenty of fluids during the day (8-10 glasses).

Tip: Avoid cranberry juice, it is very acidic.

Activity

Your physical activity is to be restricted especially during the first one to two weeks. During this time, use the following guidelines but remember these are only guidelines. Some operations are more extensive and require longer recovery; some are less complicated and require less time to recover.

  • No lifting heavy objects (anything greater than 10 lbs.).
  • No strenuous exercise—limit stair climbing to minimum.
  • No sexual intercourse until cleared by your doctor.
  • No severe straining during bowel movements—take a laxative if necessary.

Bowels

It is important to keep your bowels regular during the postoperative period. Straining with bowel
movements can cause bleeding. A bowel movement every other day is reasonable. Use a mild
laxative if needed, such as: Milk of Magnesia (2-3 Tablespoons) or Dulcolax tablets. Call our office if you
continue to have problems.

Medication

You may resume your pre-surgery medication unless told not to. In addition, you may be
given stool softeners and an antibiotic to prevent infection. These should be taken as prescribed
until the medication is finished unless you are having an unusual reaction to one of the drugs.

Problems you should report to us:

  • Fevers over 100.5º F
  • Heavy bleeding or clots (See notes above about blood in urine).
  • Inability to urinate.
  • Drug reactions (Hives, rash, nausea, vomiting or diarrhea).
  • Severe burning or pain with urination that is not improving.

West Coast Urology
Lawrence R. Paletz, MD
Ernest H. Agatstein, MD FACS
Shahrad Aynehchi, MD FACS
Sepehr Nowfar, MD, MPH

Inglewood (310) 673-3333     Downey (562) 923-0706     Los Alamitos (562) 449-4183