A Complete Guide to Bladder Tumor Resection (TURBT)

Bladder tumors, whether benign or cancerous, require prompt medical attention. Fortunately, modern medicine offers several effective treatment options, especially for early-stage cases. One of the most widely used and successful procedures is Transurethral Resection of Bladder Tumor (TURBT). This minimally invasive surgery is used both to diagnose and treat bladder cancer while preserving bladder function.

In this guide, we’ll explore what TURBT involves, when it is recommended, how the procedure is performed, possible risks, and what recovery typically looks like.

What is Bladder Tumor Resection?

Bladder Tumor Resection, commonly referred to as TURBT, is a surgical procedure designed to remove tumors located on the inner lining of the bladder. It is typically performed using a medical instrument called a resectoscope, which is inserted through the urethra, allowing the surgeon to reach the bladder without making any external incisions.

This technique is considered minimally invasive and is most commonly used for non-muscle-invasive bladder cancer (NMIBC). In addition to removing the tumor, the tissue that is collected during the surgery is sent to a laboratory for analysis, which helps determine whether the tumor is cancerous and what treatment should follow.

When is TURBT Recommended?

TURBT is usually recommended in cases where abnormal growths are identified in the bladder, either through imaging or cystoscopy. It is commonly performed when patients present symptoms such as:

• Blood in the urine (hematuria)

• Persistent urinary tract infections

• Pain or burning during urination

• Increased frequency or urgency to urinate

Even if the tumor is asymptomatic, early removal through TURBT can help prevent further complications or progression to muscle-invasive disease. TURBT is also used for patients who require follow-up treatment after previous bladder surgeries, particularly if tumors have reappeared.

Types of TURBT Procedures

There are different types of TURBT procedures, depending on the purpose of the intervention:

1. Diagnostic TURBT is performed to confirm the presence of a tumor and assess whether it is cancerous. A biopsy is taken and analyzed to determine the grade and stage of the cancer.

2. Therapeutic TURBT involves complete or partial removal of known tumors. It is typically the first-line treatment for superficial bladder cancers.

3. Repeat TURBT may be performed after the initial surgery if there are concerns about residual tumor tissue or if the tumor was found to be high-grade. This repeat procedure ensures that all abnormal tissue is removed and aids in accurate staging.

The TURBT Procedure: Step-by-Step

Preoperative Preparation

Before the surgery, patients undergo imaging tests such as ultrasound, CT scan, or MRI, and diagnostic cystoscopy. These procedures help locate and evaluate the size, number, and nature of the bladder tumors.

During the Surgery

TURBT is usually carried out under general or spinal anesthesia. A resectoscope is gently passed through the urethra into the bladder. Using a small electric loop or laser at the tip of the resectoscope, the surgeon removes the visible tumor tissue. Bleeding vessels may be cauterized, and the bladder is typically flushed to clear any remaining tissue.

The entire procedure generally takes between 30 minutes to an hour, depending on the complexity and size of the tumor.

After the Surgery

Following TURBT, a catheter may be placed in the bladder to help drain urine and prevent clot formation. Most patients can expect to stay in the hospital for a few hours or overnight for monitoring. The catheter is usually removed within a day or two.

Risks and Potential Complications

While TURBT is a relatively safe procedure, as with all surgeries, there are some risks involved. These may include:

• Temporary bleeding or blood in the urine
• Urinary tract infection (UTI)
• Difficulty or pain during urination
• Perforation of the bladder wall (rare)

Patients should inform their doctor immediately if they experience fever, severe abdominal pain, or persistent bleeding after the procedure.

It is also important to understand that bladder tumors, especially cancerous ones, have a relatively high recurrence rate. As a result, patients are typically placed on a structured follow-up schedule, including regular cystoscopy exams to detect any regrowth at an early stage.

Recovery and Follow-Up Care

Most patients recover from TURBT within one to two weeks. During this time, it is advisable to avoid strenuous physical activity, drink plenty of fluids, and refrain from smoking, which is a known risk factor for bladder cancer recurrence.

Depending on the biopsy results and cancer risk, additional treatments may be recommended. These could include intravesical therapy, such as Bacillus Calmette-Guerin (BCG) or chemotherapy agents, administered directly into the bladder to reduce the risk of recurrence.

Regular follow-up is essential. For patients with low-risk tumors, checkups might be scheduled every 6 to 12 months. For those with high-risk tumors, more frequent surveillance is necessary.

Conclusion

Bladder Tumor Resection (TURBT) is a cornerstone in the management of non-muscle-invasive bladder tumors. Its minimally invasive nature, diagnostic capabilities, and therapeutic effectiveness make it the first choice for treating many bladder cancers. While the procedure itself is generally safe and quick, ongoing follow-up is critical due to the high recurrence rate of bladder tumors.

Patients experiencing symptoms such as blood in the urine, frequent urinary infections, or painful urination should seek medical evaluation promptly. Early detection followed by appropriate surgical treatment can significantly improve outcomes and long-term bladder health.