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Superficial Bladder Cancer: Transurethral Resection of Bladder Tumour (TURBT)

Transurethral resection of the prostate (TURP) is a surgical treatment for tumours in the bladder.

The bladder, like the entire urinary tract, is covered by a layer of cells called transitional cells. The wall of the bladder is formed of three layers, the mucosa, submucosa and the muscle.  If the cancer is confined to the mucosa and submucosa, it is known as superficial cancer and treatment consists of removal of the tumour (transurethral resection). If, however, it affects the muscle, it is known as infiltrating cancer. This requires partial or complete removal of the bladder, generally followed by radiotherapy or chemotherapy.  This distinction is used to determine which is the most appropriate treatment for the patient.

The most common signs and symptoms of bladder cancer are: presence of blood in urine (hematuria), pain when urinating or overly frequent urination. However, there are other bladder and prostate conditions that share these signs and symptoms (infections, blockages, benign tumours, etc).

Benefits of the operation

Transurethral resection is performed for diagnostic and therapeutic purposes. Transurethral resection provides tissue which is biopsied to obtain information about the depth the tumour has reached and the tumour grade and growth pattern. This information is decisive when it comes to
determining the treatment and prognosis.

Medical-technical description

An appliance (resectoscope) with a metal handle connected to an electronic scalpel is inserted through the urethra into the bladder and the cancerous tissue is cut out under direct vision. There is therefore no need to make any incisions in the area.

About the operation

The surgery is generally performed under spinal anaesthesia, although in some cases general anaesthesia is required. It takes between 15 and 60 minutes depending on the size of and location of the tumour. Patients must stay in hospital for between two and five days.

Before the operation

  • A full study of your medical history to determine the details of the surgery.
  • You will be visited by the anaesthetist who will explain the anaesthetic technique to you.
  • You will have an intravenous line fitted for administration of fluids and painkillers.
  • You must not eat or drink for 6 hours before your operation.
  • Do not wear underwear or removable dentures. You must remove all metal objects (such as rings, bracelets, earrings, body piercings, etc).

Post-operative care

  • Your bladder will be washed out through a catheter that you will have to wear for not longer than 24 hours.  Flushing out your bladder will prevent the formation of clots in the surgical site.
  • Six hours later you will be able to start drinking liquids. It is recommended you drink water between two and three litres a day.
  • You will be given painkillers if you feel any discomfort.
  • You should move your feet and bend and stretch your legs to encourage blood flow.
  • You will not be released until you have urinated at least once.
  • The first few times you urinate you will notice a little stinging and you may pass some clots and a little blood.
  • When you are released you will be given a medical report with the date of your follow up visit with your doctor and a prescription of the treatment you should follow.
  • The healing process takes between two and four weeks. During this time, urination can be slightly uncomfortable, although no special treatment is required.
  • After you are released, you are recommended to lead a quiet life, drink plenty of water and not to take anticoagulant drugs and to keep an eye on your blood pressure.
  • After two or three weeks your doctor will have the results of the biopsy, which will provide guidance regarding the need to perform other treatments or more surgery.

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