Most people with non-muscle-invasive bladder cancer have an operation called transurethral resection of bladder tumour (TURBT).
The TURBT is done during a cystoscopy under a general anaesthetic. It takes 15–40 minutes, and does not involve any external cuts to the body.
A slender hollow tube with a light and a camera, known as a cystoscope, is passed through the urethra and into the bladder. The surgeon may use a wire loop on the cystoscope to remove the tumour through the urethra. Other methods for destroying cancer cells include burning the base of the tumour with the cystoscope (fulguration), or using a high-energy laser.
If the cancer has reached the lamina propria or is high grade, you may need a second TURBT 2–6 weeks after the first to make sure that all microscopic cancer has been removed. If the cancer comes back after standard treatment, your surgeon may do another TURBT or might suggest removing the bladder in an operation known as a cystectomy.
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What to expect after surgery
Recovery time – Most people who have TURBT surgery need to stay in hospital for 1–2 days. It is important to give your body time to heal after the surgery. When you go home, avoid any heavy lifting, strenuous exercise or sexual activity for 3–4 weeks.
Drips and tubes – You may have a thin 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. It is important to keep drinking lots of water to flush the bladder and keep the urine clear.
Surveillance after surgery
Bladder cancer can come back even after it has been successfully removed from the bladder. You will need to have regular follow-up cystoscopies to help find any new tumours as early as possible, whether you have further symptoms or not. This is called surveillance cystoscopy.
How often you need to have a cystoscopy will depend on the grade and stage of the cancer and how long since it was diagnosed.
For more information about follow-up appointments after surgery, ask your surgeon or see Follow-up appointments.
Side effects of TURBT surgery
The most common side effects after a TURBT are blood in the urine, issues storing urine, and bladder infections. It is normal to see blood in your urine for up to two weeks after the procedure.
Signs of problems with storing urine or bladder infection include: feeling cold, shivery, hot or sweaty; burning or pain when urinating; needing to urinate often and urgently; passing blood clots; or difficulty passing urine. To prevent infection, your doctor may prescribe a course of antibiotics.
Video: What is surgery?
Watch this short video to learn more about surgery.