Transurethral Resection of Bladder Tumour (TURBT)

A bladder tumour is an abnormal growth of the cells in the urohelium of the bladder.

A transurethral resection of a bladder tumour or TURBT is a diagnostic as well as therapeutic modality. The abnormal mass is removed endoscopically & sent for examination.

Risk factors

Common risk factors to develop bladder cancer are smoking, family history of bladder cancer, history of having worked in the dye chemical or print industry, repeated bladder infections i.e. cystitis, have previously had bladder cancer; or develop a bladder infection called schistosomiasis, caused by a parasite in certain tropical countries esp. Egypt.

Bladder cancer occurs most commonly in people between 50 and 70 years of age. The most common symptom of bladder cancer is blood in the urine (hematuria). You may also have symptoms mimicking urine infection pain when you pass urine and the urge to pass urine frequently.

What are the alternatives?

TURBT is the first treatment offered for all bladder tumours because it is not only a therapeutic but also a diagnostic modality.

Preoperative Workup

Consent form

You will be asked to sign a consent form to confirm that you agree to have the procedure and understand what it involves. The risks and benefits are explained prior to the procedure. Do not hesitate to ask any doubts & queries that come to your mind.

Before the operation

You will come into hospital either the afternoon before or the morning of your surgery. Most patients can leave hospital within 48 – 72 hours of their procedure. You should follow the Urofort preoperative check list which gives you streamlined information about the things you need to complete prior to the procedure.

Please remember to bring all the medicines that you are taking alongwith the prescriptions of the prescribing physicians when you come into hospital. If you are taking aspirin, clopidogrel or warfarin, you may need to stop taking them for 3-5 days prior to surgery. Please do not stop taking any medicine unless told to do so by your prescribing physician. You also need to take written clearance from your prescribing physician for the surgery that you need to undergo.

You will not be allowed to eat or drink anything for six hours before your surgery.

You will then be shifted to the theatre as per your slotted time.

Anaesthesi

A TURBT is either carried out under a general or spinal anaesthetic. A general anaesthesia makes the patient unconscious during surgery. A spinal anaesthesia is where a thin special needle is inserted into your back and anaesthesia medicines injected around the spinal nerves.In this anesthesia you will be awake, but will not feel anything from your waist downwards.

At times it is preferable to have general anesthesia with deep muscle paralysis for bladder masses that are on lateral bladder wall, to avoid risk of obturator jerks & hence bladder perforations. This shall be discussed with you prior to the procedure, if need be.

Surgery

TURBT entails complete removal of macroscopically visible abnormal masses; if technically possible. An endoscope is introduced into the bladder from the urethra to resect the mass. Though visible incisions are not seen on the body, cuts are made inside the bladder to achieve tumor clearance. Separate superficial & deep specimens are sent to plan definitive treatment for the patient. At times tumor is technically not resectable (anterior wall masses). In such a scenario we try to take tissue for diagnosis & deep samples if possible. The biopsy report tells if the masses are malignant, their grade and stage the cancer has reached. This helps decide any future treatment that is needed as well as surveillance protocols.

Post Operative Management

A Foleys catheter is kept at the end of the procedure & irrigation started, to prevent any clot formations & urinary blockages. The catheter is kept for 1 – 3 days depending on case-to-case basis.

Once the operation is over, you will be taken to the recovery room to allow the anesthesia to wear off. You will be taken back to your ward when you are fully awake, usually 2-4 hours after being observed in recovery.

Follow-up

The histopathology report is available 5-7 days after the procedure. It helps decide whether further treatments are required or not. These details shall be discussed when you meet Dr Manav Suryavanshi in follow-up visit with the report.

The follow up visit can be arranged at Urofort (+91-9910103545) or the hospital where you have been offered treatment by us as per your convenience.

In case it′s a superficial tumor, one needs to follow up with surveillance cystoscopies or restaging TURBT depending upon the histopathology report which shall be discussed in detail with you by Dr Manav.

TURBT FAQ’s

When can normal activities be resumed?

You will usually be able to go home about 48 – 72 hours after your procedure.

We advise you:

Some people experience a mild burning sensation on passing urine after their surgery. This usually settles after a few days. Drink more water, if it still does not settle contact Urofort for appointment to rule out urinary tract infection.

Contact our Hospital Emergency/ Casualty/ Urology Helpline (+91-9560398928) if you:

Bleeding (Grades & significance)

Please make sure you have been given an appointment before you leave hospital. The results from your TURBT will determine your future follow-up. Dr Suryavanshi will discuss this with you when you come for your follow-up appointment. If you have bladder cancer and do not need any further invasive treatment you will need to have regular check cystoscopies to check the cancer has not returned. These will initially be at three monthly intervals and then progressively less often if your bladder remains cancer free. If you need further treatment or your tumour(s) return we will discuss this with you at your follow-up appointment.

If you want any further information or any help, do not hesitate to contact Urofort coordinator for an appointment at +91-9910103545.

For Emergency call Urology Helpline – +91-9560398928.

Sources of cancer information

Urofort Cancer Care at Urofort, Aggarwal Cyber Plaza I, Netaji Subhash Place, Pitampura, Delhi – 110034 offers information and support for patients with cancer, their relatives and friends. For more information, call +91-9910103545 or email urofort@gmail.com.

Urofort Cancer Care has a patient information website, with information on all types of urology cancer and treatment options. Visit www.urofort.com

    • to speak to us about how much time you will need off work after your operation. This will depend on your recovery and the type of work that you do. Usually you will need to take about 10 to 14 days off, but if your job involves lifting or heavy work, you may need to take three to four weeks off work.
    • to start gentle exercises about a week after your surgery, but please do not do anything too strenuous, for a month
    • do not drive again until you feel comfortable and are able to perform an emergency stop. Please check with your insurance provider before starting to drive again.
    Anticipated problems at home?
    • develop a temperature, have pain and persistent burning when you pass urine;
    • do not pass urine for eight hours (unless you are asleep);
    • pass large clots of blood; or
    • if you have persistent bleeding.
      • Light pink – Do not bother
      • Rooh Afza like color & consisitency – Drink more water.
      • Thick clots and or difficulty in passing urine, Contact Urology Helpline (+91-9560398928). Patient may need to get readmitted for Cystoscopy &/SOS proceed.
      • How to keep a Check for further recurrences?
      • Who can I contact for further information?

For More Information

Meet us at

Medanta Kidney & Urology Institute

Medanta – The Medicity

Sector 38, Gurgaon, Haryana – 122001, India

For appointment Call+91-9910103545

Email – info@urofort.com

Web address – www.manavsuryavanshi.com