North Bay Ontario

TURBT

Transurethral resection of bladder tumour

A TURBT (or transurethral resection of bladder tumour) is a endoscopic minimally invasive surgical procedure that is used to remove a bladder tumour / mass that has been identified by either imaging or previous cystoscopy.

During a TURBT your Urologist will use a cystoscope to visualize the bladder mucosa and then utilize an electrocautery resectoscope to cut out any bladder tumours that are visualized.


The Procedure

Please arrive at the day surgery unit on time. You can expect to be at the hospital for several hours; however the surgery itself will last between 1-2 hours.


Risks

All surgical procedures have inherent risks associated with them.  Despite these risks being very low, we believe it is important that all patients who choose a surgical option are aware of the potential for unwanted outcomes.

TURBT is a very safe procedure, however, the risks do include anesthetic complications such as MI, Stroke, adverse drug reaction, or even death.  Specific to the surgery, blood loss and the need for a transfusion are a real, but very small risk.  difficulty voiding and the need for a catheter can occur. Urinary overactivity is a common side effect of this surgery that usually resolves with time. Urinary incontinence is a very rare complication that can also occur.  Bladder perforation can also occur due to the resection of cancerous tissue.  This can sometimes require a catheter to be left in place for an additional period of time.  An extremely rare complication is a perforation into the "intra-peritoneal" space.  If this were to happen, a further surgery into the abdomen to repair the hole can be necessary.  


When you arrive

A general anesthetic or a regional anesthetic (such as a spinal that numbs below the level of the block) will be administered by the Anesthetist. Once frozen or asleep you will be placed into a lithotomy position and a rigid camera will be gently inserted into the urethra with the aid of lubrication.  You should not experience any discomfort.  This allows visualization of the bladder mucosa and allows your Urologist to proceed with the surgery.  The tumour(s) will then be removed with an electrocautery loop.  ​

After TURBT

After the TURBT you will be able to resume normal activities including driving within a few days.  Most patients do not complain of significant pain following the surgery, however discomfort with voiding can be expected for a few weeks.  Pain medications are rarely needed. 

Depending on the size and amount if tissue needing to be removed a TURBT can be either an "in-patient" or an "out-patient" procedure.  

Out-patient

For the majority of bladder tumours, most patients will be brought to the recovery unit with a foley catheter in place.  Depending on the amount of bleeding will determine the length of time the catheter needs to be left in place.  Most patients will have the catheter removed in the recovery unit and then be discharged home once they have voided.  

In-patient
Occasionally, for very large or bloody tumours, you may have to stay overnight in hospital.  If this is the case then you can expect to spend 1-2 days in hospital.  Following the surgery a catheter will be in place in the bladder with 3 ports.  The first port will allow inflation of the catheter balloon.  The second port will allow the flow of sterile saline into the bladder.  The third will allow the flow of fluid out of the bladder.  This is a technique called "CBI" or "continuous bladder irrigation".  This will be continued until the urine is mostly clear of blood (pink / red colour change is normal).  Usually on day 1 or day 2 after the surgery the catheter will be removed for a "Trial of Voiding".  You will be discharged once you are able to void.  Occasionally patients remain unable to void following this surgery.  In this situation the catheter will be left in place for a further period of time, typically 1-2 weeks.


When Should I Call my Doctor?

You should contact our office if significant bleeding or burning persists for more then a few days, if you are having a hard time passing your urine, or if you develop a fever.

Q&A

1. What is a resectoscope?

     It is a small retractable piece of surgical equipment that passes within a rigid cystoscope.  It allows for an electrocautery loop to deliver energy to cut out abnormal tissue such as a tumour or excessive prostatic adenoma.

2. Will it hurt?

     The procedure should not be uncomfortable and is performed under either a regional or general anesthetic.  You may feel pressure, burning, or an urge to urinate, but it should not be "painful".

3. How long will it take?

     The procedure length is determined by the amount of abnormal tissue present and the amount of tissue to be removed.  This can range from 30 minutes to 120 minutes. 

Urology North

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