Transurethral Resection of Bladder Tumor (TURBT)

Treatment Overview:

Transurethral Resection of Bladder Tumor is a treatment for Bladder Cancer. Nearly 80% of all bladder cancers are diagnosed as superficial bladder cancers. Once positively diagnosed and biopsied, many superficial bladder cancers (SBC) can be surgically removed by a procedure known as a transurethral resection of a bladder tumor, or TURBT. For invasive bladder cancer, more aggressive therapy (cystectomy or bladder removal) is necessary to stop its progression to metastatic bladder cancer.

TURBT is the most conservative surgery for bladder cancer. However, TURBT still has some side effects, including possible bleeding and infection, perforation of the bladder, and blocked ureters. Transurethral resection generally takes place in the hospital with the patient under general anesthesia. The doctor inserts a cystoscope (a small camera) in through the urethra and into the bladder. A small tool with a wire loop at the end is inserted through the cystoscope.

A high-frequency electric current passes through the wire tool removing and burning cancer cells. This method is called fulguration. In some situations, fulguration will not be enough to eradicate the tumor. In superficial bladder cancers that recur following TURBT, the doctor will use a laser to obliterate the tumor. However, because laser surgery also destroys surrounding tissue, if the tumor has not been previously biopsied and positively diagnosed as bladder cancer, its use is not recommended.

Follow-up to TURBT:

Transurethral resection is often a successful treatment for patients with low-risk cancers. These cancers are described as noninvasive, papillary cancers. The noninvasive characteristic keeps them from penetrating into deeper layers of tissue, but does not prevent their recurrence. Up to 70% of patients with superficial bladder cancer have some recurrence within five years of treatment.

Therefore, follow-up therapy is an important part of post transurethral resection therapy. Follow-up therapy includes a cystoscopic evaluation three months after the initial TURBT treatment and then every six months for an additional year. If cancer reappears, follow-up cystoscopy and urinalysis is typically performed every three months for the first year and every six months for an additional three to five years.