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What Is TURBT and How Is It Performed?

Transurethral Resection of Bladder Tumour (TURBT) is a surgical procedure used to diagnose and treat tumours inside the urinary bladder without making any cuts on the outside of the body. The surgeon uses a long, thin instrument called a resectoscope that goes into the bladder through the urethra (the tube urine passes through) to find and remove tissue that may be cancerous. This minimally invasive approach allows doctors to both take tissue for analysis (biopsy) and often remove the tumour entirely.

TURBT is the main first step in managing bladder tumours, especially when cancer is suspected or has been seen on imaging tests. It helps doctors confirm the type, stage, and grade of the tumour, which guides further treatment.

Purpose & Benefits of TURBT

● Diagnoses bladder cancer by removing tissue for detailed lab study.

● Removes visible tumours from the bladder lining.

● Helps determine cancer stage and grade, crucial for planning treatment.

● Minimally invasive, no external cuts mean less pain and faster recovery.

● It is usually done on an outpatient basis, so hospitalisation may not be needed.

● Can reduce the risk of cancer spread when tumours are found early.

Who May Need TURBT?

TURBT is recommended for people who:

● Have tumours been seen on bladder imaging tests or cystoscopy?

● Have blood in the urine (haematuria) or other symptoms that suggest bladder cancer.

● Need a tissue sample to confirm if cells are cancerous.

● Have a small bladder tumour that can be removed during the procedure.

● Require follow-up surgery if the initial TURBT did not remove all tumour tissues.

Your doctor will examine your health history and tests before recommending TURBT to make sure it is the right option for you.

Types of TURBT

Standard TURBT

This is the usual form, where the doctor uses the resectoscope to cut away tumours from the bladder lining and send samples to the lab.

Enhanced Visualization TURBT

Some centres use special dyes or blue light cystoscopy to make tumours glow, helping the surgeon see and remove more cancer cells.

Re-TURBT (Second Look TURBT)

Sometimes a follow-up TURBT is done weeks later to make sure all tumour tissue was removed and to check for any new growth.

TURBT Procedure: Step-by-Step

1. Preparation: Your doctor will give instructions, such as fasting before surgery and stopping certain medicines.

2. Anaesthesia: You will receive general anaesthesia (asleep) or spinal anaesthesia (numb from the waist down).

3. Inserting the Scope: The surgeon gently inserts the resectoscope through the urethra into the bladder.

4. Visualising the Tumour: A camera on the scope sends live images to a screen so the surgeon can see the tumour clearly.

5. Removing Tumor Tissue: Using a small loop on the scope, the surgeon cuts away tumour cells. Heat may be used to seal blood vessels and stop bleeding.

6. Catheter Placement: After tissue removal, a catheter may be placed in the bladder to drain urine and prevent clots.

7. Completion: The instruments are removed, and you are moved to recovery. The removed tissue is sent to a lab for pathology tests.

The surgery usually takes about 15–90 minutes, depending on how many tumours are present and their size.

Recovery & Aftercare

● You may rest in the hospital a few hours or overnight if needed.

● Your urine may be pink or bloody for a few days, which is common.

● Some discomfort or a burning feeling when urinating is normal for a short time.

● Drinking plenty of fluids helps flush the bladder and speed recovery.

● Avoid lifting heavy objects and strenuous activity for a few weeks as advised.

● Full healing may take 2–4 weeks.

Your doctor will tell you when to return for follow-up visits or additional tests to check healing and plan further treatment.

Risks & Possible Complications

TURBT is generally safe, but there are some possible risks:

● Bleeding, sometimes requiring further treatment.

● Urinary tract infection (UTI) that may need antibiotics.

● Injury to the bladder wall or urethra.

● Bladder perforation (rare).

● Anaesthesia reactions depend on your health and medications.

Your doctor will explain personal risks and how to watch for signs of complications.

TURBT vs Other Bladder Cancer Treatments

● TURBT vs Open Surgery: TURBT is less invasive because it doesn’t require cuts in the skin. Open surgery may be needed if cancer has spread deeper.

● TURBT vs Biopsy Only: While biopsies only take small tissue samples, TURBT removes the tumour itself and also tests tissue for staging.

● TURBT vs Chemotherapy: TURBT can be followed by local chemotherapy placed directly in the bladder to help prevent recurrence.

TURBT is often the first step in bladder cancer care, and further treatments may be advised depending on pathology results.