A telescopic operation to remove a bladder tumour through the natural urinary passage. It both treats the visible cancer and provides the tissue that determines its stage and grade. No cuts are made in the skin.
Transurethral resection of bladder tumour (TURBT) is usually the first operation performed when a growth is found in the bladder, most often after it has been seen at cystoscopy. The whole procedure is carried out through the urethra — the natural channel through which you pass urine — so there are no incisions in the skin.
A telescope is passed along the urethra into the bladder, and the tumour is removed in pieces using a fine electrical loop or laser. The base of the tumour is then sealed to stop bleeding. A small amount of the underlying muscle is included in the sample, because examining the muscle is what allows the pathologist to determine whether the cancer has invaded the muscle wall — the single most important factor in planning treatment.
TURBT therefore has two distinct purposes: it removes the visible tumour, and it provides the tissue needed to establish the stage and grade of the cancer. In some cases, a single dose of chemotherapy may be instilled into the bladder shortly after the operation to reduce the chance of the tumour returning.
02
Before your procedure
As the procedure is usually performed under general or spinal anaesthetic, you will be asked to fast beforehand — typically six hours for food, with water permitted up to two hours prior.
Tell Dr Tan’s team if you take blood-thinning medication, as this may need to be adjusted or paused before the operation.
A urine test is checked beforehand — any infection is treated first, as operating in the presence of infection carries added risk.
Arrange for someone to take you home, as you will have had an anaesthetic and should not drive that day.
03
Risks and benefits
Diagnosis and treatment together
The visible tumour is removed and the tissue needed to stage and grade the cancer is obtained in a single operation.
No skin incisions
The entire procedure is performed through the urethra, so there are no external cuts and recovery is usually quick.
Accurate staging
Including muscle in the sample allows the pathologist to determine invasion depth, which guides all subsequent treatment.
Common
Blood in the urine
Light blood-staining and a burning sensation when passing urine are expected for one to two weeks, and settle with good hydration.
Common
Urinary symptoms
Discomfort, burning, and frequency and urgency of urination are expected for the first week.
Common
Temporary catheter
A catheter is often left in for one to two nights to drain the bladder and allow any bleeding to settle.
Uncommon
Urinary infection
Some patients develop an infection needing antibiotics. Report fever, chills, or worsening burning to the team.
Uncommon
Need for a repeat procedure
For certain high-grade or T1 tumours, a second TURBT is planned a few weeks later to confirm complete removal and accurate staging.
Rare
Bladder perforation
A small hole in the bladder wall is uncommon and usually managed by leaving the catheter in for longer; occasionally further treatment is required.
Rare
Bleeding requiring treatment
Heavier bleeding needing bladder washout or, very occasionally, a return to theatre is uncommon.
04
Aftercare and recovery
1
Catheter and discharge
Most people go home the same day or after one night, once the urine has cleared sufficiently and the catheter has been removed.
2
Hydration
Drink plenty of fluid in the first days to help flush the bladder and reduce the risk of clots.
3
Return to activity
Avoid heavy lifting and strenuous exercise for about two weeks. Most people return to light activities within a few days.
4
Results and plan
The tissue is examined over about a week. Dr Tan will then discuss the stage, grade, and the recommended plan, which may include surveillance, further treatment, or a second TURBT.
Was muscle included in the sample, so the stage can be confirmed?
Will I need a dose of chemotherapy into the bladder after the operation?
Am I likely to need a second TURBT?
When will I get my results, and how will they be explained to me?
What will my follow-up and surveillance involve?
What symptoms should prompt me to seek urgent advice?
Disclaimer
This information is for general education and is not a substitute for personal medical advice.
Content adapted from the British Association of Urological Surgeons (BAUS) and the American Urological Association (AUA) patient information resources.