TURBT — Transurethral Resection of Bladder Tumour

What is TURBT?

Transurethral Resection of Bladder Tumour (TURBT) is an endoscopic operation to remove abnormal tissue from the inner lining of the bladder. It is the cornerstone of diagnosis and initial treatment for bladder tumours. A fine telescope (cystoscope) is passed through the urethra — no skin incisions are required — and a resecting loop uses electrical energy to cut away tumour tissue, which is then collected and sent to the pathology laboratory for detailed examination.

TURBT serves two simultaneous purposes: it removes the visible tumour and provides tissue for the pathologist to determine the tumour type, grade, and depth of invasion. This pathological information is essential for planning any further treatment.

Who needs TURBT?

TURBT is recommended when a bladder tumour has been identified — most commonly following investigation of visible blood in the urine (haematuria), or when an abnormality is seen on imaging such as an ultrasound scan or CT urogram. Less commonly, tumours are found incidentally on scans performed for other reasons.

The procedure is appropriate both for patients with newly discovered bladder tumours and, in some cases, for those requiring a repeat resection to ensure complete removal of a previously identified tumour or to obtain a deeper tissue sample.

What to expect: before, during, and after

Before the procedure

Blood tests, urine tests, and imaging will have been arranged before the operation. You will be asked to fast. If you take blood-thinning medication, you will be advised when to pause it. A flexible cystoscopy may have already been performed to evaluate the tumour before the operation.

During the procedure

TURBT is performed under general or spinal anaesthesia. The resectoscope is introduced through the urethra and the tumour is resected in layers using a wire loop. Bleeding is controlled with diathermy. A catheter is placed at the end of the procedure, and continuous bladder irrigation is commenced.

After the procedure

You will typically stay in hospital for one to two nights. The catheter and irrigation are removed once the urine runs clear, usually within 24–48 hours. Some blood in the urine for a short period after the catheter is removed is expected. You should drink plenty of fluids and avoid strenuous activity for two weeks.

Results and ongoing care

The pathology report will describe the tumour type, the grade (how abnormal the cells appear), and whether the tumour has invaded the muscle layer of the bladder. This staging information determines the next steps in management.

Most bladder tumours at first presentation are non-muscle-invasive. These are managed with a combination of surveillance cystoscopy and, for higher-risk tumours, intravesical instillation treatments (BCG or Mitomycin C). Muscle-invasive disease requires a different treatment pathway, which your urologist will discuss in detail.

Bladder tumours have a tendency to recur, which is why ongoing cystoscopic surveillance is an important part of long-term care.