Transurethral Bladder Biopsy

What is a transurethral bladder biopsy?

A transurethral bladder biopsy is a procedure done to look at the bladder and remove a small piece for tests in the lab.

When is it used?

You may have this procedure done if you have:

• suspected cancer in your bladder
• blood in the urine
• a problem with your bladder
• frequent urination.

This procedure may not cure the problem, but it helps your healthcare provider make a more accurate diagnosis.

How do I prepare for a transurethral bladder biopsy?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow your healthcare provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.

Follow any other instructions your healthcare provider gives you. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight on the day of procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a local, spinal, or general anesthetic. A local or spinal anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, puts you to sleep, and keeps you from feeling pain.

Your healthcare provider will insert a scope through the urethra into your bladder. The urethra is the passageway that carries urine from the bladder and out of your body when you urinate. The scope is a thin, lighted tube with lenses like a microscope. Water will flow through the tube and into the bladder to fill and stretch it so that your provider has a better view. Your provider will examine the bladder and use another tool with the scope to take a sample of any growth or suspicious area that he or she finds for tests.

What happens after the procedure?

You may go home the same day you have the procedure if you can urinate and are not bleeding a lot. While you are recovering from surgery, you may have trouble controlling your bladder. You may notice blood in your urine or have trouble urinating. If this happens, rest in bed and call your healthcare provider if it continues more than 1 day or gets worse. Drink a lot of water and avoid all heavy activity such as lifting for 3 or 4 weeks. Avoid becoming constipated by eating fiber and drinking fluids.

Ask your provider when you should come back to discuss results of the biopsy. Ask your provider what other steps you should take.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your provider.
• A local or spinal anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia.
• You may have Infection or bleeding.
• The bladder could be damaged and need to be repaired with more surgery.
• If you are in a lot of discomfort, you may not be able to pass urine.
• Rarely, a scar may form inside the urethra and cause it to become narrow. As a result, you may need to have the urethra stretched to widen the passage.

You should ask your healthcare provider how these risks apply to you. Precautions are taken, of course, against all of these risks.

When should I call my healthcare provider?

Call your provider right away if:

• You are bleeding more than you had expected.
• You are unable to urinate.
• You develop increasing pain with urination.
• You develop a fever.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.