What is a TURBT?

Bladder cancer is most frequently found during a cystoscopic evaluation where a lighted scope is inserted through the urethra into the bladder. A papillary appearing tumor on the bladder wall suggests bladder cancer and the patient is then scheduled for resection (removing piecemeal through a scope) called transurethral resection of bladder tumor (TURBT). It is generally performed in the hospital setting with the patient asleep under anesthesia. During the procedure, a scope with a special electric cutting element is inserted through the urethra into the bladder through which the tumor is removed. All tumor chips or pieces are flushed from the bladder and sent for pathological analysis. The bed of the tumor site is coagulated and a catheter with continuous irrigation flushing is inserted to prevent problems with postoperative bleeding. Overnight monitoring in the hospital may be required for larger tumors.

What is the purpose of a TURBT?

A TURBT allows your urologist to both diagnose and potentially treat various bladder disorders. The most common indication for a TURBT is bladder cancer. 75% of bladder cancers that are discovered are superficial in nature. In other words, most bladder cancers grow only on the surface of the bladder wall and not deep into the bladder wall. This allows your urologist to completely remove the cancer and avoid more invasive surgery.

The information that is gained from this procedure will inform your surgeon as to the type of tumor or abnormality that is in the bladder, as well as how extensive it is. The cancer grade and degree of invasion into the bladder wall can determine the next step in your bladder cancer treatment.

What are the common symptoms following my TURBT?

As with most procedures that require endoscopy of the urinary tract, there is often burning and some mild discomfort when urinating for several days. It is also common to have a change in the force of the urinary stream for several days and perhaps even 1-2 weeks.

Bleeding from the resection site is possible immediately after the procedure. It will appear as reddish coloring in the tubing of your catheter. Also, small clots may be produced and evacuated by the nurse at the bedside. Usually, this bleeding will clear in 1-2 days.

It is also very common for a patient to experience a small episode of repeat bleeding 1-2 weeks following TURBT. Typically, this is from a small healing scab that is released from the urinary that resolves quickly.

When should I seek advice from my physician?

A patient should contact their physician if they run a 101 degree or greater fever or if they begin passing clots that are larger than 1 inch in diameter. Some will have cherry colored urine, but may also experience darker burgundy-colored urine and at times brown-colored urine. The color of urine typically is determined by how long a time has passed since the bleeding began. Drinking 48 ounces of water daily after TURBT can help avoid larger clots that may be problematic.