Transurethral Bladder Tumor Resection

A transurethral bladder tumor resection is a procedure in which the doctor removes a tumor from your bladder. The operation is referred to as "transurethral" because it is performed through the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body.

Tumors are removed because they cause complications such as bleeding, infection, or obstruction. Malignant tumors may spread through the bladder to surrounding tissues or through the bloodstream to other parts of your body.

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow your health care provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.

Follow any other instructions your doctor gives you. If you are to have general anesthesia, eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight on the day of the procedure. Do not even drink coffee, tea, or water.

You are given a local or general anesthetic. A local anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as if you are in a deep sleep, and prevents you from feeling pain.

The doctor puts a scope into your urethra and up into the bladder. He or she lets water pass through the tube and into the bladder to fill it up. The doctor examines the bladder. He or she uses a heated wire or a laser to shave the tumor down a piece at a time. The doctor flushes the pieces of tumor out of the bladder with water and removes the tube. He or she sends the pieces of tumor to the lab to be analyzed.

You may go home that day or may be in the hospital for a few days, depending on the extent of the operation. You will have a catheter, or tube, in the bladder to help it drain and to flush out any remaining pieces of tumor and any blood clots that have formed. The doctor will remove the catheter after the bleeding stops.

While you are recovering from surgery, you may have trouble controlling your bladder. The scab inside the bladder may become loose and bleed. If this happens, you may notice blood in your urine or have trouble urinating because of blood clots. Rest in bed and call the doctor if it continues more than 1 day or gets worse.

Drink a lot of water. For 3 to 4 weeks avoid all heavy activity such as lifting and any unnecessary strain. Try to avoid becoming constipated.

Your doctor will want to do a follow-up exam of your bladder. Ask your doctor what other steps you should take and when you should come back for a checkup.

The tumor may be removed, and you may no longer have bladder pain or cancer. By having the tumor removed in this manner, you will avoid the additional pain, discomfort, cost, and longer hospital stay of an operation performed with an open cut through your abdomen.

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.
• A regional anesthetic may not numb the area enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Regional anesthesia is considered safer than general anesthesia.
• The bladder could be damaged.
• If you are in a lot of discomfort, you may not be able to pass urine.
• Rarely, the muscle around the urethra may be damaged during this operation. This could make it difficult for you to control urine flow.
• Rarely, a scar may form inside the urethra and cause it to become narrow. As a result, you may need to have the urethra stretched to widen the passage.
• The tumor may grow again, and this operation may need to be repeated.
• Infection or bleeding may occur.

You should ask your doctor how these risks apply to you.

Call the doctor immediately if:

• You find bright red blood in the urine.
• You develop a fever.
• You are unable to urinate.

Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.