Most people with non-muscle-invasive bladder cancer have an operation called transurethral resection of bladder tumour (TURBT). This is done under general anaesthetic using a rigid cystoscope. A TURBT takes 15–40 minutes and does not involve any cuts to the outside of the body.
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The rigid cystoscope is passed through the urethra into the bladder so the surgeon can see the inside of your bladder on a monitor. The surgeon may remove the tumour through the urethra using a wire loop on the end of the cystoscope. Other methods for destroying the cancer cells include burning the base of the tumour with an electrical current (fulguration) or a high-energy laser.
If the cancer has spread to 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 are removed. If the cancer comes back after initial treatment, your surgeon may do another TURBT or suggest removing the bladder in an operation known as a cystectomy.
For more on this, see our general section on Surgery.
What to expect after a TURBT
Most people who have a TURBT stay in hospital for 1–2 days. Your body needs time to heal after the surgery.
Having a catheterYou may have a thin, flexible 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.
Side effectsSide effects may include blood in the urine, needing to pass urine more often 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.
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.
When to get helpContact your medical team promptly if you:
Check-ups after surgery
Cancer can come back even after a TURBT has removed it from the bladder. You will need 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. For more on this see Follow-up appointments and ask your surgeon.
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Prof Dickon Hayne, Professor of Urology, UWA Medical School, The University of Western Australia, Chair of the Bladder, Urothelial and Penile Cancer Subcommittee, ANZUP Cancer Trials Group, and Head of Urology, South Metropolitan Health Service, WA; A/Prof Tom Shakespeare, Director, Radiation Oncology, Coffs Harbour, Port Macquarie and Lismore Public Hospitals, NSW; Helen Anderson, Genitourinary Cancer Nurse Navigator (CNS), Gold Coast University Hospital, QLD; BEAT Bladder Cancer Australia; Mark Jenkin, Consumer; Dr Ganessan Kichenadasse, Lead, SA Cancer Clinical Network, Commission of Excellence and Innovation in Health, and Medical Oncologist, Flinders Centre for Innovation in Cancer, SA; A/Prof James Lynam, Medical Oncology Staff Specialist, Calvary Mater Newcastle, NSW; Jack McDonald, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Tara Redemski, Senior Physiotherapist – Cancer and Blood Disorders, Gold Coast University Hospital, QLD; Prof Shomik Sengupta, Consultant Urologist, Eastern Health and Professor of Surgery, Eastern Health Clinical School, Monash University, VIC.
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