What Is a TURBT?

A transurethral resection of bladder tumor (TURBT) is a procedure that is done to remove tissue from the bladder that is suspicious for cancer. This procedure can both diagnose and treat cancer in the bladder.

This article will review what to expect before, during, and after the procedure.

Purpose of the Test

A TURBT is a surgical procedure used to remove tissue from the bladder to be evaluated under the microscope to look for cancer cells, which is done as part of the evaluation for bladder cancer.

If someone presents with symptoms concerning bladder cancer, a TURBT is one of the procedures that may be required to get a diagnosis. Symptoms of bladder cancer can include:

• Blood in the urine
• Frequent urination
• Back pain
• Abdominal pain
• Unintentional weight loss

A TURBT can determine how deep into the bladder wall the cancer has grown, and it is an important part of staging the cancer. The cancer’s stage needs to be known to help determine the best way to treat it.

In an early-stage bladder cancer—meaning the cancer has not spread into deep layers of the bladder or to any other areas of the body—a TURBT may be able to completely remove all the cancer cells.

Before the Test

A TURBT is usually done under general anesthesia, which will put you to sleep during the procedure. Before any procedure with anesthesia, a few instructions need to be followed. 

• Eating and drinking is usually not allowed after midnight before the procedure. 
• Sometimes you need to stop taking certain medications—like blood pressure medications or blood thinners—before the test. The surgeon or urologist performing the procedure should tell you of any medications that need to be stopped, and for how long.
• A shower should be taken the day of the TURBT and may require the use of a special soap. The surgical team will provide instructions on when and how to shower before the procedure. 
• A driver will be needed, as driving yourself after anesthesia is not allowed. Bring an ID and insurance card, but do not bring any valuables. TURBT is often an outpatient procedure and usually does not require hospitalization after.

During the Test

After anesthesia is given, the body is moved into the position to do the procedure, and the skin in the area of the urethra is cleaned and prepped. The urethra is the tube that allows urine to exit the body from the bladder.

A rigid scope, called a resectoscope, is put into the urethra. The resectoscope is then moved up into the bladder, allowing the physician to see inside the bladder. It has a special wire at the end which allows for removal of tissue from inside the bladder. 

Once the suspicious tissue is removed, the tissue is sent to a pathology laboratory for evaluation. Tests are run to determine how deep into the bladder wall it has gone and to see what type of cells are present.

If the physician sees any other suspicious areas inside the bladder, the scope can be used in some cases to treat these areas by burning the tissue with a laser (fulguration). The physician can also put chemotherapy into the bladder to kill some of the abnormal cells lining the bladder.

After the Test

Following TURBT, a catheter may be inserted into the bladder to help drain urine. This is often temporary, and the surgical team will let you know when it can be removed.

Urination may be uncomfortable for a few days, and there may be some blood present in the urine. If you are concerned about the amount of blood in the urine, it is important to discuss your symptoms with the doctor. 

Increased fluid intake may be encouraged, and normal eating is allowed after the test. Normal activities may usually resume about a week after the procedure.

Results

Following TURBT, the tissue removed from the bladder is sent to a pathology laboratory for evaluation. The bladder is made up of multiple layers of tissue, and during the TURBT, it is likely the doctor removed a portion of tissue down to the muscle layer.

As the tissue is evaluated in pathology, it will be determined how far into the bladder layers the cancer had grown.

After a TURBT, the doctor will likely make a follow-up appointment about a week or two later to review the results and discuss treatment options as needed.

Risks of the Test

As with any procedure, there are some risks associated with TURBT, although it is often a safe and well-tolerated procedure. Some of the risks can include:

• Developing a urinary tract infection after the procedure
• Excessive bleeding
• Risks associated with getting anesthesia
• A hole being formed in the bladder after the procedure (perforation)
• Need for repeat TURBT if all the tissue was not removed

Again, these risks are rare, but it’s important to be aware of them before having the procedure. The anesthesia team and surgeon will discuss any additional risks that may be present.

A Word from Verywell

A TURBT is a safe and common procedure that is done to diagnose and treat bladder cancer. Though some risks are associated with it, it can be a very important test that is needed. Talk with your healthcare team about any specific worries you may have about this procedure or the results.