Shall we talk about transurethral resection of bladder cancer (TURBT)?

Has your doctor told you or someone you know that you have bladder cancer? Then you probably have a lot of questions about the TURBT surgery. Don't be afraid to think about it. It is a very common and successful treatment. Today, we will talk briefly about what TURBT is, how it is done, and what you need to know before and after undergoing it.

Simply put, what is TURBT?

The full name of TURBT is Transurethral Resection of Bladder Tumor . Although the name may sound complicated, it is actually quite simple. It is a procedure that both diagnoses and treats the disease in a single operation.

Imagine that you have a small tumor inside your bladder. Now the doctor wants to know exactly if it is cancer, if so, how deep it has grown into the bladder wall (stage), and how different its cells are from normal cells (grade). That is why the TURBT surgery is performed.

This involves inserting a long, thin instrument with a camera attached (called a cystoscope) through your urethra into your bladder, finding the tumor, and cutting it out. This doesn't involve any major incisions outside your body . Everything happens through your urethra. The removed tumor is then sent to a lab to be examined by a pathologist.

How to prepare before TURBT surgery?

Your doctor will give you clear instructions about what to do before surgery. Following these instructions exactly can greatly reduce the risk of unwanted complications.

What happens during the surgery?

Before the surgery, the anesthesiologist will examine you and decide whether to give you general anesthesia, which puts you completely to sleep, or spinal anesthesia, which numbs only your lower back. Most often, you will be given general anesthesia. This means that you will not feel anything during the surgery.

In some cases, the doctor may put a special liquid (dye) into your bladder through a tube (catheter) about an hour before the procedure to help see the tumor more clearly. This liquid glows when a special light is used during the procedure, allowing the doctor to see exactly where the tumor is.

Steps of the surgery

1. Insertion of the instrument: The doctor carefully inserts the cystoscope through your urethra and into your bladder.

2. Removing the cyst: The cyst is found inside the bladder and is cut into pieces using a small cutting device.

3. Stopping bleeding: If bleeding occurs from the site where the tumor was removed, cauterize the area with a small electrical device to stop it.

4. Catheterization: After surgery, if necessary, a catheter is placed to drain urine and blood from the bladder. This also helps prevent blood clots. Sometimes, saline is passed through this tube to flush the bladder. Not everyone needs a catheter.

What will happen after the surgery?

You will not feel any pain during the surgery. However, after the surgery, you may feel a little pain or burning for about a week or two, especially when urinating. This is normal. You may also have a little blood in your urine. This will also subside in a few days.

Do I need chemo after TURBT?

Some people will need chemotherapy after TURBT. If the cancer has not spread outside the bladder, your doctor may recommend intravesical chemotherapy, which is given directly into the bladder through a tube. The first dose may be given at the same time as the surgery. If the cancer has spread (metastasized) to other parts of the body, you may need chemotherapy given through a vein. This will all be decided based on your biopsy results.

Do you need to stay in the hospital?

You will be kept in the hospital for observation for a few hours after the surgery. The catheter will be removed before you are sent home. However, if the tumor is large or if there is a lot of bleeding, you may be sent home with the catheter for a few days.

After going home:

• Drink plenty of water as the doctor says.
• You can eat and drink normally.
• Stop lifting weights and doing strenuous work for a few weeks.
• The doctor will call you when your biopsy report comes in. Ask in advance when and how you will receive it.

When to talk to the doctor

If you experience any of these symptoms after surgery, call your doctor immediately or go to the hospital's Emergency Department (ETU) .

• Fever .
• Passing large amounts of blood or large blood clots in the urine.
• Urine has a foul odor or a foul taste .
• Sudden, unexpected pain .
• Difficulty urinating.

Sometimes, 4-6 weeks after the first surgery, you may need to have another surgery (a `second-look TURBT`) to make sure the tumor has been completely removed. Your doctor will explain all of this to you.

TURBT, bladder cancer, bladder tumour, cystoscopy, cancer surgery, urethritis, urology