Why do I need a TURBT?
This procedure is indicated if a tumour has been identified in your bladder during a telescopic examination (cystoscopy).
What is the bladder?
The bladder is a hollow muscular organ in the pelvis that stores urine. The urine, which is produced by the kidneys, drains into the bladder down 2 narrow delicate tubes called ureters. When you go to the bathroom, urine is expelled from the bladder through the urethra.
What does the procedure involve?
TURBT is a minimally invasive operation for removing tumours from the bladder. Under a general or spinal anaesthetic, a telescope is passed up the urethra. The tumour is cut away with diathermy. Afterwards a catheter is usually left for 1-2 days.
Getting ready for the operation
If you smoke, try and cut down or preferably stop, as this reduces the risks of heart and chest complications during and after the operation. If you do not exercise regularly, try and do so for at least half an hour per day e.g. brisk walk or swimming.
You will be given a form to have routine pre-operative blood tests and a urine test to exclude infection before your surgery – if you have lost your form please contact Dr Nathan’s rooms.
Please Note: If you are on medication to thin the blood such as warfarin, aspirin, Plavix, Iscover, Brilinta, Pradaxa, Xarelto or supplements such as fish oils please let Dr Nathan know at least 2 weeks before surgery as these medications may need to be discontinued to prevent excessive bleeding at the time of surgery. You can continue to take your other medications as normal.
Speak to the anaesthetist about your anaesthetic (details available form my receptionist).
What are the risks, consequences and alternatives associated with having a TURBT?
Most procedures are straightforward; however as with any surgical procedure there is a chance of side effects or complications.
Common
- Temporary mild burning, bleeding or frequency of urination after the procedure.
- Need for additional treatments to bladder in attempt to prevent recurrence of tumours, including drugs instilled into bladder.
- Need for regular checks due to risk of recurrent tumours.
Occasional
- Urine infection requiring antibiotics.
- No guarantee of cancer cure by this operation alone.
- Recurrence of bladder tumour and / or incomplete removal.
Rare
- Delayed bleeding requiring removal of clots or further surgery.
- Damage to drainage tubes from kidneys (ureters) requiring additional therapy.
- Injury to urethra causing delayed scar formation.
- Perforation of the bladder requiring temporary insertion of a catheter or open surgical repair.
Alternatives to TURBT
- Open surgical removal of bladder.
- Chemotherapy.
- Radiotherapy.
What should I expect after the operation?
After your operation you will normally go back to the surgical ward. You can start eating and drinking as soon as you recover from the anaesthetic.
Pain
Because there are no external cuts, this procedure is relatively pain free. You may experience some discomfort from the catheter, but this is usually easily treated with mild painkillers such as paracetamol.
Catheter
A urinary catheter is a tube that runs from the bladder out through the tip of the penis and drains into a bag. It is important to drain the urine in this way until the urine as clear. Your catheter is usually removed 24-48 hours after your operation.
Once the catheter has been removed, and you are passing water normally, you will be able to go home.
Discharge information and home advice
Bleeding
It is quite normal to see an occasional show of blood after discharge. This is due to the healing of the operation site. If you see blood, simply increase your fluid intake. If you have prolonged bleeding, or increasing difficulty passing water, please contact the hospital.
Pain
Mild painkillers such as Paracetamol should be enough to deal with any pain.
Exercise
You should take it easy for a month, although it is important to take some gentle exercise like walking, as you will be at a slight risk of developing a blood clot in your legs.
- During the first 4 weeks you should not:
- Lift or move heavy objects.
- Dig the garden.
- Housework.
- Carry shopping.
Work
Recovery takes 6-8 weeks from your operation date. Your doctor will be able to advise you when it will be safe to return to work as this depends on your occupation. The nurse can provide a sick note for your hospital stay, once home they should be obtained from your GP.
Driving
You may resume driving a motor vehicle after 1-2 weeks if you feel well and do not have significant pain or discomfort. You should initially commence this with small trips and you should avoid any long car trips for at least four weeks.
Disclaimer
This information is intended as a general educational guide and may not apply to your situation. You must not rely on this information as an alternative to consultation with your urologist or other health professional.
Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.