Most people with non-muscle-invasive bladder cancer need to have an operation called transurethral resection of bladder tumour (TURBT). This is done during a rigid cystoscopy under a general anaesthetic. It takes 15–40 minutes, and does not involve any external cuts to the body.
Learn more about:
- How the surgery is done
- Surveillance after surgery
- What to expect after surgery
- Video: What is surgery?
A thin hollow tube with a light and camera, known as a cystoscope, is passed through the urethra and into the bladder. The surgeon may use a wire loop on the cystoscope to remove the tumour through the urethra. Other methods for destroying the cancer cells include burning the base of the tumour with the cystoscope (fulguration) or a high-energy laser.
If the cancer has reached the lamina propria or is high grade, you may need a second TURBT 2–6 weeks after the first procedure to make sure that all cancer cells have been removed. If the cancer comes back after initial treatment, your surgeon may do another TURBT or might suggest removing the bladder in an operation known as a cystectomy.
Surveillance after surgery
Cancer can come back even after a TURBT has removed it from the bladder. You will need to have regular follow-up cystoscopies to help find any new tumours in the bladder as early as possible. This approach is known as surveillance cystoscopy.
How often you need to have a cystoscopy will depend on the stage and grade of the cancer and how long since it was diagnosed. See follow-up appointments for more information and ask your surgeon.
What to expect after surgery
Most people who have a TURBT need to stay in hospital for 1–2 days. Your body needs time to heal after the surgery.
Contact your medical team promptly if you: feel cold, shivery, hot or sweaty; have burning or pain when urinating; need to urinate often and urgently; pass blood clots; or have difficulty passing urine.
Having a catheterYou may have a thin tube (catheter) in your bladder to drain your urine into a bag. The catheter may be connected to a system that washes the blood and blood clots out of your bladder. This is known as bladder irrigation. When your urine looks clear, the catheter will be removed and you will be able to go home. If the tumour is small, there may be no need for a catheter and you may be discharged from hospital on the same day.
Flushing the bladderIt is important to keep drinking lots of water to flush the bladder and keep the urine clear.
Recovery timeWhen you go home, avoid any heavy lifting, vigorous exercise or sexual activity for 3–4 weeks.
Side effectsSide effects may include blood in the urine, problems storing urine, and bladder infections. It is normal to see some blood in your urine for up to two weeks. Your doctor may prescribe antibiotics to prevent infection.
Video: What is surgery?
Prof Dickon Hayne, UWA Medical School, The University of Western Australia, and Head, Urology, South Metropolitan Health Service, WA; BEAT Bladder Cancer Australia; Dr Anne Capp, Senior Staff Specialist, Radiation Oncology, Calvary Mater Newcastle, NSW; Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC; Dr Peter Heathcote, Senior Urologist, Princess Alexandra Hospital, and Adjunct Professor, Australian Prostate Cancer Research Centre, QLD; Melissa Le Mesurier, Consumer; Dr James Lynam, Medical Oncologist Staff Specialist, Calvary Mater Newcastle and The University of Newcastle, NSW; John McDonald, Consumer; Michael Twycross, Consumer; Rosemary Watson, 13 11 20 Consultant, Cancer Council Victoria.
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