Transurethral resection of bladder tumor

A surgical procedure in which a tumor inside the bladder is shaved out endoscopically through the urethra, providing both diagnosis and treatment.

Indication

A bladder tumor identified on cystoscopy in the presence of blood in the urine (hematuria)
An intravesical mass detected on imaging (CT, MRI, ultrasound)
Recurrence of previously diagnosed non-muscle-invasive bladder cancer
Re-look surgery (re-TUR) at 4-6 weeks for high-risk non-muscle-invasive bladder cancer
Tissue sampling required for diagnosis and staging of bladder tumor
Follow-up evaluation after intravesical therapy (BCG, mitomycin)

No solid food or liquids for 6-8 hours before the procedure
Blood-thinning medications are temporarily stopped with the physician's approval
Blood tests, urine culture, ECG, and chest X-ray are completed
Active urinary tract infection is treated with antibiotics
Prophylactic antibiotics are administered before the procedure

The patient is placed in the lithotomy position; spinal or general anesthesia is administered
A thin endoscope (resectoscope) is advanced through the urethra into the bladder
The interior of the bladder is systematically inspected; the location, number, and size of the tumor are determined
The tumor is shaved out in layers using an electrical loop or laser
An additional sample including muscle tissue is taken from the base of the tumor to assess invasion
At the end of the procedure a urinary catheter is placed; early intravesical chemotherapy may be administered if indicated

1-2 day hospital stay; the catheter is left in place for 1-3 days
Plenty of fluids support continuous bladder irrigation
Intravesical BCG or chemotherapy is planned according to the pathology result
Cystoscopy follow-up every 3 months in the first year; intervals are extended in later years according to risk group
In high-risk cases, a re-look operation (re-TUR) is recommended after 4-6 weeks

Is this procedure open or closed?

TURBT is performed entirely as a closed procedure through the urethra. No incision is made on the abdomen.

How long will I stay in the hospital?

Most patients stay in the hospital for 1-2 days after the procedure and are discharged once the catheter is removed.

Why is a re-look surgery (re-TUR) needed?

In high-risk non-muscle-invasive bladder tumors, a second procedure performed 4-6 weeks later removes any residual tumor tissue and confirms staging.

Can the tumor recur?

Bladder tumors have a high tendency to recur; therefore, long-term follow-up with regular cystoscopy is required.

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