Transurethral Resection of Bladder Tumor (TURBT)

This card describes what transurethral resection of bladder tumor, usually shortened to TURBT, involves and what the main health bodies say about recovery and follow-up. A tumor in the bladder can be a worrying finding, and the information here is general. The treating team decides what applies to each person, and questions are always welcome.

What it is

TURBT is an operation to remove tumors from the lining of the bladder without a cut in the skin. Cancer Research UK explains that the surgeon passes a thin rigid tube called a cystoscope into the urethra, the tube that carries urine out of the body. Small instruments passed down the cystoscope cut tumors out of the bladder lining.

The US National Cancer Institute (NCI) uses the name transurethral resection with fulguration. It describes a tool with a small wire loop that removes the cancer, or burns it away with high-energy electricity, which is the fulguration. The procedure builds on cystoscopy, and the glossary explains terms such as stage and grade.

Why it is done

TURBT has two linked purposes. Cancer Research UK describes it as usually the first treatment for non-muscle-invasive bladder cancer, meaning cancer confined to the inner lining. It is also a diagnostic step. The removed tissue goes to a laboratory, which reports the stage (how far the cancer has grown through the bladder wall) and the grade (how abnormal the cells look under the microscope).

Those results help the team decide what comes next. The NCI says the stage and grade of the cancer, a person's overall health and their preferences all shape the treatment plan, and the NHS says surgery is the main treatment for bladder cancer. Cancer Research UK says a second TURBT is sometimes carried out within 6 weeks, usually when the cancer is high risk, to make sure all of it was removed and to check how far it had grown.

How it is done, in outline

Cancer Research UK says TURBT is usually done in a day surgery unit under general anesthesia, although some hospitals use a spinal anesthetic that numbs the body below the waist. It takes between 15 and 90 minutes. Most hospitals give an antibiotic injection beforehand.

The surgeon looks at the inside of the bladder, removes any tumors, and then seals the area with a probe to stop bleeding. Some centers use special lighting, such as narrow band imaging or a light-sensitive dye with blue light, to help show abnormal areas, though these methods are not available everywhere. Cancer Research UK also says a single dose of chemotherapy is usually placed into the bladder within 6 hours of the operation to treat any cells left behind and lower the chance of the cancer coming back.

Recovery

After surgery, Cancer Research UK says some people go home the same day, while others stay overnight or for a couple of days. A catheter may drain urine for a short time and is usually removed before discharge. Blood in the urine can last up to 3 days, and some bleeding 10 to 14 days later is described as normal. Passing urine may burn or sting for several days, and drinking plenty of fluid is advised.

After a general anesthetic, someone should take the person home and stay overnight, and for 24 hours the person should not drive, drink alcohol or use heavy machinery. Catheter care is covered in urinary catheters after surgery, and the broader healing picture is in recovery and rehabilitation.

What happens next depends on the laboratory results. Cancer Research UK says that when the cancer is low risk, people might need no further treatment and instead have regular cystoscopies, while intermediate or high risk cancers may need more treatment. The NCI notes that some of the tests used for diagnosis and staging may be repeated as follow-up.

Risks

Cancer Research UK describes TURBT as a safe procedure and lists the possible risks: bleeding, infection, and rarely a small tear in the bladder wall that usually settles with a catheter for a few days. Very rarely, surgery is needed to repair it.

Cancer Research UK says to contact the hospital immediately if bleeding gets worse, if there are blood clots in the urine, if passing urine is very painful, or if you cannot pass urine and have severe pain. Signs of infection it lists include a high temperature, shivering and cloudy or foul-smelling urine. Bleeding 10 to 14 days after the operation that does not stop within 24 hours should also prompt a call to the hospital advice line. A wider view of bladder procedures is on the bladder and prostate procedures page.

Questions to ask your clinician

• What do you expect to find, and how will the tissue results be explained to me?
• When will I get the stage and grade results, and what do they mean for my next steps?
• Might I need a second TURBT, and how would that decision be made?
• Will I be offered chemotherapy in the bladder after the operation, and when?
• Will I have a catheter, and for how long?
• What follow-up cystoscopies or tests should I expect, and how often?
• Which symptoms after I go home mean I should call the hospital right away?