Treating Bladder Cancer: Transurethral Resection (TUR)
Cystoscopy is a way for your healthcare provider to look at the inside of your bladder. A thin tube with a tiny camera on it is passed through your urethra and into your bladder. This tube is called a cystoscope or resectoscope. Problems in the urinary tract can be found and sometimes even treated with cystoscopy.
If cancer is found and it's in an early stage (small) and is growing slowly (low grade), it may be taken out during cystoscopy. This is called a trans urethral resection (TUR) or trans urethral resection of bladder tumor (TURBT). The surgery to remove the tumor is done through the scope. No cut is made in your skin. TUR can be used to diagnose or treat bladder cancer.
Most of the time, the tissue taken out during TUR is tested to see exactly what it is and if more treatment is needed.
TUR is most often done in a hospital as an outpatient procedure. So you go home the same day. If the tumor is large, you might stay overnight.
You'll be given medicine so you don’t feel pain during the procedure. This is called anesthesia. If you have regional anesthesia, just the lower part of your body is numbed. Medicine may also be used to make you feel sleepy. If you have general anesthesia, you'll be in a deep sleep during the procedure.
During the procedure
A cystoscope or resectoscope is passed through your urethra and into your bladder. The lining of the bladder is looked at through the scope. If tumors are found, they're taken out if possible. A wire-like cutting tool in the scope is used to do this. After the tumor is removed, electricity might be used to seal off blood vessels.
A sample of cells (biopsy) from the tumor and normal-looking tissue may be taken out. These samples are looked at under a microscope. This is done to look for cancer and, if it's found, to see how deeply it has grown into the bladder wall. In some cases, a laser is then used to burn any remaining tumor away.
After the procedure
Here is what to expect after TUR:
After the procedure, a thin, flexible tube (called a catheter) might be put in your bladder. It drains urine and blood out of your bladder while you heal. The tube may be in for a few days.
Bladder tumors can come back (recur) after treatment. To be sure that all cancer cells are killed, TUR may be followed by other types of treatment, like intravesical therapy. This is when medicines are put into the bladder to kill the cancer cells.
TUR might be done again if the biopsy shows that all the cancer cells weren't taken out.
Risks and possible complications of TUR
All procedures have risks. Risks of TUR include:
Blood or blood clots in the urine
Bladder spasms and irritation
Pain when peeing
Urinary frequency (having to pee more often than normal)
Urinary tract infection
Most of these go away on their own or can be treated, and they don't last very long.
If TUR is repeated many times, it can cause scarring and the bladder may not be able to hold much urine. This can lead to needing to pee often (urinary frequency) and trouble controlling your urine (incontinence).
Working with your healthcare provider
Your provider will talk with you about TUR. They'll help you understand why it's being done, what it will be like, and how you may feel during and after TUR. Be sure you know what problems to watch for and when you need to call your provider. Also be sure you know what number to call to get help after office hours and on weekends and holidays.