What is a transurethral bladder biopsy?

A transurethral bladder biopsy is a procedure in which the doctor inserts a cystoscope, a tubelike instrument with a light, into your bladder to examine the bladder and remove a small piece for analysis.

When is it used?

You may have this procedure done if you have:

• poor control over your urine

• trouble urinating

• frequent urination

• blood in the urine

• a problem with your bladder

• cancer in your bladder.

As an alternative, you could choose not to have treatment, recognizing the risks of your condition. You should ask your doctor about this choice.

How do I prepare for a transurethral bladder biopsy?

Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow instructions provided by your doctor. No special preparation is needed for local or spinal anesthesia. 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 procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a local, spinal, or general anesthetic. A local or spinal 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 will insert a scope through the urethra (the tube from the bladder to the outside of the body) into the bladder. He or she will let water pass through the tube and into the bladder to fill it up. The doctor will examine the bladder and, by looking through the tube and using another tool, take a sample of any growth he or she finds. The doctor will then remove the tube and send the sample to the lab to be tested.

What happens after the procedure?

You may go home the same day you have the procedure if you can urinate and are not bleeding a lot. While you are recovering from surgery, you may have trouble controlling your bladder. You may notice blood in your urine or have trouble urinating. If this happens, rest in bed and call the doctor if it continues or gets worse. Drink a lot of water and avoid all heavy activity such as lifting for 3 or 4 weeks. Avoid becoming constipated by eating fiber and drinking fluids.

Ask your doctor what other steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

This procedure may not cure the problem, but it will help the doctor make a more accurate diagnosis.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• A local or spinal anesthetic may not numb the area quite 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. Local or spinal 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 hard for you to control your urine.

• 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.

• Infection or bleeding may occur.

You should ask your doctor how these risks apply to you. Precautions are taken, of course, against all of these risks.

When should I call the doctor?

Call the doctor immediately if:

• You are bleeding more than you had expected.

• You are unable to urinate.

• You develop increasing pain with urination.

• You develop a fever.

Call the doctor during office hours if:

• You have questions about the procedure or its result.

• You want to make another appointment.