Transurethral Bladder Tumor Resection

What is a transurethral bladder tumor resection?

A transurethral bladder tumor resection is surgery done to remove a tumor from the bladder. "Transurethral" means that it is done through the urethra. The urethra is the passageway that carries urine from the bladder to the outside of the body.

When is it used?

Tumors are removed because they are cancerous and can cause problems such as bleeding, infection, or blockage. Cancerous tumors may spread to other parts of your body.

Examples of alternatives are:

• having a radical cystectomy, which is removal of the bladder and surrounding lymph nodes and other nearby organs, such as the prostate gland or uterus, tubes, and ovaries
• choosing not to have treatment while recognizing the risks of your condition.

You should ask your healthcare provider about these choices.

How do I prepare for a transurethral bladder tumor resection?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. 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 the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a regional or general anesthetic. A regional 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 prevents you from feeling pain.

Your healthcare provider will insert a scope through the urethra into your bladder. 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 uses a heated wire or a laser to shave the tumor down a piece at a time. The pieces of tumor are flushed out of the bladder with water. Pieces of the tumor are sent to the lab for tests.

What happens after the procedure?

You may go home that day or may be in the hospital for a few days, depending on the extent of the operation. You will have a catheter, or tube, in the bladder to help it drain and to flush out any remaining pieces of tumor and any blood clots that have formed. Your healthcare provider will remove the catheter after the bleeding stops.

While you are recovering from surgery, you may have trouble controlling your bladder. The scab inside the bladder may become loose and bleed. If this happens, you may notice blood in your urine or have trouble urinating because of blood clots. Rest in bed and call your provider if it continues more than 1 day or gets worse.

Drink a lot of water. For 3 to 4 weeks avoid all heavy activity such as lifting and any unnecessary strain. Try to avoid getting constipated.

Your provider will want to do a follow-up exam of your bladder. Ask your provider what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

This is a way to remove a tumor without complete removal of the bladder. After the procedure you may no longer have bladder pain or cancer. By having the tumor removed with a scope through the urethra, you will avoid the additional pain, discomfort, cost, and longer hospital stay of an operation performed with an open cut in your belly.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your provider.
• A regional anesthetic may not numb the area 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. Regional anesthesia is considered safer than general anesthesia.
• The tumor may grow again, and this operation may need to be repeated.
• 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 and may need a catheter to drain 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.

When should I call my healthcare provider?

Call your provider right away if:

• You see bright red blood in your urine.
• You develop a fever.
• You are unable to urinate.

Call during office hours if:

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