TURBT is a procedure that involves the removal of bladder tumors through the urethra without making any external incisions. This approach is commonly used for early-stage bladder cancer and is both diagnostic and therapeutic. TURBT helps doctors determine the extent and aggressiveness of the tumor while simultaneously treating it.
What is TURBT Used For?
- Bladder Tumor Removal
TURBT is primarily used to remove tumors in the bladder, especially those suspected of being cancerous.
- Diagnosis and Staging
This procedure helps determine the nature of the tumor—whether it’s benign or malignant—and identifies how deeply it has invaded the bladder wall.
- Treatment for Superficial Tumors
TURBT is effective for removing non-muscle-invasive bladder cancer (superficial tumors) that are limited to the inner layers of the bladder.
How Does TURBT Work?
During TURBT, the surgeon inserts a thin, specialized instrument called a resectoscope through the urethra into the bladder. This tool allows the surgeon to visualize the bladder and use an electric loop to remove the tumor or abnormal tissue. The tissue is then sent to a pathology lab to determine the type and stage of the tumor.
The TURBT procedure is typically performed under general or spinal anesthesia, ensuring the patient is comfortable throughout the surgery.
Pre-Procedure Preparation
- Initial Assessment
Before TURBT, patients undergo a complete medical evaluation, including imaging tests such as cystoscopy or CT scans, to assess the size and location of the bladder tumor.
- Anesthesia
The procedure is performed under either general or spinal anesthesia, depending on the patient’s condition and the size of the tumor.
TURBT Procedure Steps
- Resectoscope Insertion
A resectoscope is inserted through the urethra into the bladder. The resectoscope allows the surgeon to view the inside of the bladder on a video screen.
- Tumor Removal
Using the resectoscope’s electric loop, the surgeon carefully cuts away the tumor tissue. Any abnormal or suspicious-looking areas are also resected for further examination.
- Bleeding Control
After the tumor is removed, the surgeon uses electrical energy to cauterize the site, minimizing bleeding and preventing recurrence.
- Sample Collection
If needed, tissue samples are sent to a pathology lab for histological analysis to determine the type and aggressiveness of the tumor.
Duration of the Procedure
The procedure usually lasts between 30 minutes and 1 hour, depending on the size and number of tumors. Most patients can return home the same day, but some may require an overnight stay for observation.
Recovery after TURBT is generally smooth, but patients should follow specific guidelines to ensure a successful healing process.
Immediate Post-Surgery Recovery
- Mild Discomfort
After TURBT, patients may experience some mild discomfort or burning during urination. This is normal and typically resolves within a few days.
- Blood in the Urine
It is common to notice blood in the urine after the procedure. This may last for a few days and is not a cause for concern unless it is heavy or persistent.
Activity Restrictions
- Avoid Strenuous Activities
Patients should avoid heavy lifting, strenuous exercises, or any activities that could strain the bladder for at least two weeks after surgery.
- Hydration
Drinking plenty of water is essential to help flush out any remaining blood clots and promote healing of the bladder lining.
Follow-Up Care
- Cystoscopy
A follow-up cystoscopy is usually scheduled a few weeks after the TURBT procedure to check for residual tumor cells and ensure the bladder is healing properly.
- Intravesical Therapy
In some cases, patients may require additional treatments like intravesical chemotherapy or immunotherapy to reduce the risk of recurrence.
Long-Term Outlook
The success of TURBT largely depends on the stage and grade of the tumor. Patients with non-muscle-invasive bladder cancer generally have a good prognosis, but regular follow-up is crucial to monitor for any recurrence.
Although TURBT is considered a safe and effective procedure, there are some potential risks and complications that patients should be aware of.
Potential Risks and Complications
- Infection
A urinary tract infection (UTI) may develop after the procedure. Symptoms include fever, pain, and a frequent urge to urinate. Antibiotics are usually prescribed to prevent or treat any infections.
- Bleeding
Mild bleeding after TURBT is common, but in rare cases, significant bleeding may occur, requiring additional treatment.
- Bladder Perforation
Although rare, there is a risk of bladder perforation during the procedure. This can usually be managed with a catheter, but surgery may be required in severe cases.
Preventing Complications
Patients can reduce their risk of complications by following all post-operative instructions, staying hydrated, and attending all follow-up appointments. If any unusual symptoms arise, such as severe pain, heavy bleeding, or signs of infection, it is essential to contact the healthcare provider immediately.
The cost of TURBT can vary based on several factors, including the complexity of the case, the healthcare facility, and whether additional treatments are required.
Key Factors Influencing Cost
- Extent of the Procedure
If multiple tumors are present or if the tumor is large, the complexity of the surgery may increase the cost.
- Hospital vs. Outpatient Settings
Procedures performed in a hospital setting are generally more expensive than those performed in outpatient clinics.
- Surgeon’s Expertise
Surgeons with extensive experience in bladder cancer treatment may charge higher fees due to their specialized skills.
Insurance Coverage
Most health insurance plans cover TURBT, especially when performed for the diagnosis and treatment of bladder cancer. Patients should confirm coverage with their insurance provider and inquire about any out-of-pocket expenses.
Out-of-Pocket Costs
For patients without insurance or with high deductibles, some healthcare facilities offer payment plans to help manage the costs of the procedure.
