What is a 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.

When is it used?

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.

As an alternative to this operation, 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 tumor resection?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. 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 regional 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 the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a regional or general anesthetic. A regional 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 put a scope into your urethra and up 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. He or she will use a heated wire or a laser to shave the tumor down a piece at a time. The doctor will flush the pieces of tumor out of the bladder with water and remove the tube. He or she will send the pieces of tumor to the lab to be analyzed.

What happens after the procedure?

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 the 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 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.

What are the benefits of this procedure?

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.

What are the risks associated with this procedure?

• 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.

When should I call the doctor?

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.