This minor surgery is usually the first treatment you have for early bladder cancer.
What it is
The operation is called a transurethral resection of bladder tumour (TURBT). Your surgeon removes the tumour in your bladder through the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body.
You have it under a general anaesthetic and at the same time as the test that looks inside the bladder (cystoscopy).
Who has it
You may have surgery to remove early bladder cancer:
- during a cystoscopy test if your specialist sees a tumour
- after having tests that have showed a bladder tumour
How you have it
The surgeon puts a thin, flexible tube called a cystoscope into the tube where your urine comes out (your urethra).
The cystoscope has optic fibres inside it, and a light and eyepiece at one end. The surgeon can see down the cystoscope to look at the pictures. These may also be shown on a TV monitor.
The surgeon passes small instruments down the cystoscope to cut any tumours out of your bladder lining.
A cystoscopy is a test to look at the inside of your bladder. The bladder stores urine and when we empty it the urine passes from the bladder down a tube called the urethra and out of the body.
The urethra in men passes through the prostate gland and down the penis.
In women the urethra is much shorter and passes from the bladder down to an opening just in front of the vagina.
You have the test lying on your back on a couch. The doctor cleans around the opening to the bladder.
Then they put anaesthetic jelly into the tube where urine comes out. This doesn’t hurt but can be uncomfortable.
Once the anaesthetic has worked they put a long flexible tube called a cystoscope into the opening and up into the bladder.
You may find this uncomfortable and feel like you need to pass urine. The doctor puts water in through the scope to make it easier to see the bladder wall
The tube has a light and a camera on the end. This sends pictures to a monitor.
Looking at the monitor they examine your bladder. If they see any abnormal areas they take a tissue sample. This is called a biopsy.
After the test you may have some soreness when you pass urine. Drink plenty of fluids to help prevent infection. You may need to take antibiotics.
Contact the hospital if you have pain or bleeding which becomes worse or lasts longer than two days or if you have signs of infection such as a fever or needing to pass urine more often.
You go to hospital for this surgery, usually on the day. You are asked not eat or drink anything for at least 6 hours before the operation.
You may need a blood test and a chest x-ray before the cystoscopy. This is normal for anyone having a general anaesthetic.
You then put on a hospital gown and lie down on the theatre trolley. The trolley is wheeled to the operating theatre, where you have the anaesthetic.
In some hospitals, you may have a spinal anaesthetic instead instead of a general anaesthetic. This is an injection into your spine (epidural) so you can’t feel anything from below your waist. You may also have some antibiotics before the test.
Your surgeon may put a dye into your bladder an hour before your surgery. The dye is sensitive to light. During the surgery they shine a blue light on the bladder lining. This is called photodynamic diagnosis. It can help to show up areas of cancer more clearly.
While you are under anaesthetic, your surgeon puts uses a thin, flexible tube called a cystoscope into your urethra.
The surgeon uses the cystoscope to look at the inside of your bladder. They also pass small instruments down the cystoscope. They use these instruments to remove any tumours that look like bladder cancer.
The surgeon then uses a probe to seal (cauterise) the areas of your bladder lining from which tumours were removed. This helps to prevent any bleeding.
Cystoscopy for a man
Cystoscopy for a woman
Usually you have a dose of chemotherapy into the bladder at the end of your operation. This is to help stop the bladder cancer from coming back.
Usually you use a tube into your bladder (catheter) to drain urine into a bag at first. You can walk around with this at the hospital.
You see blood in your urine for up to 3 days. Your doctor asks you to drink lots of fluids, to flush out your bladder. This helps to protect you from getting a urine infection.
Your catheter is removed when your urine looks clear. You can then go home.