Transurethral resection of a bladder tumour (TURBT)

A TURBT is used to take a biopsy or remove cancer from inside the bladder. Transurethral means through the urethra. A TURBT:

• is the main treatment for non-muscle-invasive bladder cancer
• may be part of diagnosis and treatment for muscle-invasive bladder cancer.

A member of the surgical team will talk to you about having a general anaesthetic or a spinal anaesthetic:

• For a general anaesthetic you are given medicines to make you sleep through the operation.
• For a spinal anaesthetic, the doctor injects a drug through a thin needle into your back. This numbs the nerves from the waist down. You will be awake during the operation, but you will not feel anything.

You will be asked to wear a hospital gown and elastic stockings called TED stockings during the operation. The stockings help to prevent blood clots in your legs. You will be asked to wear these for some time after the operation.

After your surgery, the nurses will encourage you to start moving as soon as possible. They will also encourage you to do regular leg movements and deep breathing exercises. This helps to prevent problems such as chest infections or blood clots.

You will see blood in your urine (pee) at first. This is common and your nurse will monitor it. Drinking fluids will help to flush out your bladder and reduce the risk of getting a urine infection.

Sometimes, a large bag of fluid is connected to the catheter. This flushes out the bladder and helps to stop blood clots forming. Inside the catheter tube is split so fluid can flow into and out of the bladder at the same time through different channels. A drainage bag collects urine and fluid as it flows out of the catheter.

Tell your nurse straight away if:

• you feel your bladder is full
• your tummy feels uncomfortable
• the catheter stops draining.

Your nurse will take the catheter out when your urine has less blood in it. This may feel a little uncomfortable, but it should not be painful. After the nurse removes the catheter, you may find it uncomfortable to pass urine at first, but this will get better. You may also:

• need to pass urine more often
• need to pass urine urgently
• leak urine
• have some blood in your urine.

These symptoms usually get better in 1 to 2 days. Tell your doctor if they do not get better. Drinking at least 2 litres (3½ pints) of fluid every day can help to reduce these symptoms.

The surgeon sends the tumour (or tumours) they have removed to a laboratory to be looked at under a microscope. This tells your doctor more about the stage and grade of the cancer.

Getting the results of your TURBT usually takes 2 to 3 weeks. There is support available while you are waiting for your results.

 When the results are ready, they are discussed at a multidisciplinary team (MDT) meeting. Your doctor will then tell you if you need further treatment.

Having a TURBT is usually a safe procedure. But there are some possible risks or complications.

Some people may get a urine tract infection (UTI). This can happen in hospital or after you go home. Signs of an infection include:

• pain or burning feeling when you pass urine (pee)
• needing to pass urine more often
• smelly or cloudy urine
• needing to pass urine straight away
• needing to pass urine more often
• blood in your urinelower tummy or back pain
• feeling cold, shivery, hot or sweaty.

Tell your doctor if you think you have a urine infection. They can test your urine and give you antibiotics if you need them.

Some people may have bleeding for about 7 to 14 days after the operation. Tell your doctor or specialist nurse straight away if:

• the bleeding becomes heavier
• you see any blood clots in your urine or on toilet paper
• you have difficulty passing urine
• you have tummy pain.

If the bleeding continues, you may need another operation under general anaesthetic to stop it and to remove any clots.

There is a small risk of a hole being made in the bladder during surgery. This is called a perforation.

If this happens, your surgeon will explain what treatment you may need. This may be:

• the catheter is left in the bladder to allow the hole to heal, and is then removed
• an operation to close the hole.