Understanding TURBT: Bladder Tumor Removal Surgery

Image of resectoscope used in transurethral resection of bladder tumorWhat is a TURBT?

Generally, after the diagnosis of a bladder tumor, the urologist will suggest that the patient have an outpatient surgical procedure in the hospital to remove the bladder tumor . The doctor may refer to this procedure as a TURBT (transurethral resection of a bladder tumor). The TURBT will allow the doctor to examine the bladder more completely under anesthesia (general or spinal). To see inside the bladder, they use a resectoscope. Like the cystoscope, the resectoscope is introduced through the urethra into the bladder. 

Image of wire loop used to remove tumor in TURBT

This tool has a small electrified loop of wire at the end that can  resect (remove) a tumor. remove the bladder tumor. The loop also cauterizes (seals off) the blood vessels to help stop any bleeding. This is sometimes called electrocauterization or fulguration. One of the advantages of this procedure is that it can be performed repeatedly with minimal risk to the patient and with excellent results. There is less than a 10% risk of infection or injury to the bladder, and both are easily correctable.

Are there side effects to a TURBT?

The most common side effects of the TURBT are bleeding, pain, and burning when urinating. These may be intermittent and can last for up to one month. If the bladder tumor is large, the urologist may choose to leave a catheter in the patient’s bladder for a day or two. This helps to minimize problems occurring from bleeding, clot formation in the bladder or expansion of the bladder due to possible storage of excess urine or blood. Even if the tumor is small, a catheter may be inserted to rinse the bladder out if the bleeding persists.

TURBT Recovery

All the tumor specimens from the TURBT will be sent to a pathologist for review. The pathologist will confirm the type of bladder cancer and the depth of invasion into the bladder wall, if any. This will help the pathologist and your medical team determine the stage and grade of your bladder cancer. These findings, along with results from imaging such as CT scans, will determine the type and duration of further treatment if necessary.

What Happens After the TURBT?

All the tumor specimens from the TURBT will be sent to a pathologist for review. The pathologist will confirm the type of bladder cancer and the depth of invasion into the bladder wall if any. This will help the pathologist and your medical team determine the stage and grade of your bladder cancer. These findings, along with results from imaging such as CT scans, will determine the type and duration of further treatment if necessary.

After TURBT surgery, you may recover at home or spend a few days in the hospital. It is possible that you might have a catheter inserted into your urethra to help prevent blockage. The catheter tube is removed when the bleeding from surgery has stopped.

It is common to feel the need to urinate frequently after surgery. It may even burn or sting when you use the bathroom. These symptoms should become better with time. To improve these symptoms, stay hydrated by drinking fluids, it will help the healing process. Do not be alarmed if your urine appears pink. This is normal because there may be blood in your urine. Contact your doctor if these symptoms last for more than a few weeks.

Strenuous activity and heavy lifting should be avoided for around three weeks after your surgery. This means you should not lift grocery bags, children, pets or other things that cause you to strain until your doctor tells you that it is okay to. Speak to your medical team about any other recommendations they suggest.

What Are the Risks and Benefits of a TURBT?

As with any type of surgery, there are both risks and benefits to a TURBT procedure. Generally, bladder tumor biopsy and resection is considered a very safe procedure. Some of the possible risks during or after surgery include:

  • Anesthesia-related complications
  • Infections of the urinary tract
  • Bleeding after surgery
  • Perforation of the bladder

Despite these risks, TURBT procedures are typically a successful treatment for early-stage cancer of the bladder. Having a TURBT can prevent cancer from spreading into the muscle wall of the bladder.

TURBT Frequently Asked Questions

How long should I expect a TURBT to take?

The average time for the TURBT procedure is no longer than one hour. You should anticipate being put under anesthesia before the surgery. Anesthesia will allow you to be in a deep sleep during the procedure and prevent you from feeling anything.

How long will it take me to recover from a TURBT?

The first 5-7 days after surgery are crucial for recovery. During this time, you should rest and refrain from strenuous activity and exercise. This time of rest allows your bladder to heal and decreases the risks associated with bleeding. Each person is different. You may require more or less recovery time than another person.

How do I prepare for a TURBT?

Your doctor will have specific instructions, but in general, most doctors recommend that you stop taking aspirin, ibuprofen, naproxen or blood thinners for one week before surgery because these medications can cause bleeding.

About one to two weeks before surgery, you may have a pre-op appointment or consultation to make sure anesthesia is an appropriate option. Your doctor may also recommend a urine culture before surgery.

You will not be able to eat or drink anything — even water — after midnight the night before your TURBT procedure unless otherwise instructed by your doctor. It is important to follow these instructions.

You will also need a friend or family member to drive you home after the procedure if you are not spending the night in the hospital.

When should I call my doctor after my TURBT?

If you experience any of the following symptoms after your procedure, contact your doctor’s office immediately:

  • Inability to urinate
  • Blood clots in your urine that are the size of a quarter or larger
  • Fever above 101° F and/or chills
  • Nausea and vomiting

Just as with any procedure, it’s vital that you follow all the recommendations of your doctor and document any unexpected outcomes for future review.

Where can I learn more about TURBT?

Learn more by watching the Understanding TURBT and Cystoscopy webinar with Drs. Jeff Montgomery and Ken Nepple.

Click here to read our Get the Facts | TURBT (PDF), filled with advice from patients who have experienced it.

Information and services provided by the Bladder Cancer Advocacy Network (BCAN) are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment. If you are ill, or suspect that you are ill, seek professional medical attention immediately! BCAN does not recommend or endorse any specific physicians, treatments, procedures or products even though they may be mentioned on this site.