This procedure is performed to remove a growth in the bladder or bladder tumour using a surgical telescope (cystoscope). Bladder cancers are usually caused nowadays by smoking or chemical exposure and usually present with bleeding or signs of bladder irritation.
The first procedure is TURBT, which involves an anaesthetic and inspecting the bladder with a cystoscope and performing resection of the tumour through the cystoscope. The operation takes 30-60 minutes, depending on the size of the bladder tumour.
There are some risks, as with any procedure. These include bleeding, infection, pain and a very small chance of creating a hole in the bladder (perforation). The treatment of this is usually simply to leave a catheter in the bladder for 7-10 days and the hole will heal of its own accord. Very rarely a large hole is accidently made and this sometimes needs an operation to repair the bladder defect. However this is very uncommon.
After the surgery the patient is returned to the ward and can eat and drink and a catheter is left in the bladder overnight to wash out the bladder and prevent bleeding. This catheter is removed the next day and the patient can usually be discharged home. In the first few weeks after the surgery because of the healing of the bladder, patients might find that urination is urgent or that they have to go frequently and the control is not as good as before. This usually settles within 3-4 weeks as the bladder heals. The patient then returns to see Dr Pokorny within 1-2 weeks to review the results of the pathology. The pieces of bladder tumour are sent to the laboratory to be analysed under the microscope. This gives important information about the type of bladder tumour and whether it had invaded into the bladder muscle wall or not. This information helps plan future treatment.
One of the problems with bladder cancer is that it can come back over and over again. This is because the whole lining of the bladder is abnormal. This means that we need to keep monitoring patients with regular bladder checks and this is done by cystoscopy. Usually this is every 3-6 months in the first year after a TURBT and then gradually this is pushed out to yearly intervals.