Transurethral Resection of a
Bladder Tumour

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What is TURBT

Transurethral Resection of a Bladder Tumour (TURBT) is a surgical procedure primarily used in the diagnosis and treatment of bladder cancer. It involves the removal of bladder tumours off the bladder wall, using a special telescope known as a resectoscope. It also enables the collection of tissue samples for further pathological analysis, aiding in the assessment of the cancer’s stage and aggressiveness​​​​.

It is often used for early-stage bladder cancer, where the cancer has not yet invaded the muscle wall of the bladder. Given the tendency of bladder cancer to recur, TURBT may be performed multiple times for ongoing monitoring and treatment.

Pre-operative Preparations

Before undergoing TURBT, patients must undertake several pre-operative preparations to ensure the safety and effectiveness of the procedure.

  • Fasting: Patients are usually required to stop eating and drinking the night before the procedure, due to the use of anaesthesia.
  • Medication Review: A review will be made based on all medications being taken, including over-the-counter medicines and supplements. Some medications, like blood thinners, may need to be paused.
  • Hygiene Protocol: Take a bath or shower before the procedure, and avoid the use of lotions, perfumes, or deodorants thereafter.
  • Arranging Transportation: Due to the effects of anaesthesia and pain medication, patients should not drive themselves and must arrange for someone to take them home post-procedure​​.

TURBT Procedure

The TURBT procedure is a structured process involving several steps:

  1. Anaesthesia Administration: Either regional or general anaesthesia is administered to the patient.
  2. Insertion of Resectoscope: A resectoscope is inserted into the urethra, which then reaches the bladder. This instrument has a telescope for visual inspection and a small electrified wire loop for tumour removal.
  3. Bladder Examination and Tumour Resection: The interior of the bladder is examined for tumours or lesions. Identified tumours are then cut and removed using the metal loop.
  4. Biopsy Collection: Tissue samples from the tumour and healthy-looking bladder tissue are collected for pathology to determine the cancer’s stage and aggressiveness.

The entire process typically takes about an hour and is often done as an outpatient procedure, though some may require a short hospital stay​​.

Post-Procedure Care and Recovery

After undergoing TURBT, patients need to focus on rest and recovery. A catheter is often inserted to assist with urination and is usually kept in place for 1 to 3 days. Patients may experience some blood in their urine, a normal occurrence post-surgery, which should clear up within a few days. Avoid strenuous activities to prevent bleeding complications. Pain and discomfort, especially during urination, are common but should subside. Antibiotics may be prescribed to prevent urinary tract infections.

Regular follow-up appointments can help monitor for any signs of recurrence or complications. The recovery period varies, but most patients can resume normal activities within a week.

Benefits of TURBT

Minimally Invasive Approach

TURBT is less invasive compared to traditional open surgery. It avoids the need for large incisions in the abdomen, thereby reducing associated risks such as infection, longer hospital stays, and extended recovery periods.

Diagnostic and Therapeutic Utility

TURBT serves a dual purpose: it not only helps in diagnosing bladder cancer by allowing for the collection and analysis of tissue samples but also acts as an immediate treatment method by enabling the removal of detected tumours.

Tissue Sample Collection for Detailed Analysis

During TURBT, tissue samples from the tumour and surrounding healthy-looking bladder tissue are collected. These samples can undergo pathological examination to determine the presence and type of cancer cells, as well as to assess the aggressiveness and stage of the cancer.

High Effectiveness for Early-Stage Cancer

TURBT is most effective for small, single tumours that have not spread to other parts of the bladder or beyond. For these cases, the success rate of complete tumour removal and effective treatment is high.

Outpatient Procedure with Shorter Hospital Stay

The procedure is usually performed on an outpatient basis, meaning patients can often go home the same day. In some cases, a short hospital stay of 1 to 3 days may be required. This minimises the disruption to the patient’s daily life, allowing for a quicker return to normal activities.

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Potential Risks and Complications

While TURBT is generally safe, like all surgical procedures, it carries potential risks and complications:

  • Perforation of the Bladder Wall: There is a risk of accidental damage to the bladder wall during the procedure.
  • Urinary Tract Infections (UTIs): Post-operative UTIs can occur, necessitating antibiotic treatment.
  • Bleeding and Blood in Urine: Some bleeding is expected, but excessive bleeding may require further medical attention.
  • Difficulty in Urine Control: Temporary difficulty in controlling urine can occur after the catheter is removed.
  • Pain and Stinging: Patients may experience pain and stinging sensations in the lower urinary tract, particularly when urinating.
  • Incomplete Tumour Removal: In some cases, the entire tumour may not be removed, requiring additional procedures or treatments like chemotherapy or radiation.

Dr Lee Fang Jann image

Dr Lee is a urologist and kidney transplant surgeon with a broad-based expertise of all urological disorders

He has subspecialty focus on men’s health and male infertility, and special interest in minimally invasive prostate enlargement therapy and kidney stone treatment. Dr Lee has received numerous awards for service excellence such as the Service With A Heart Award (2006-2008, 2011) and the Singapore Health Quality Service Award (2016).

  • Bachelor of Medicine and Bachelor of Surgery (Singapore)
  • Membership of The Royal College of Surgeons (Edin)
  • Master of Medicine (Surgery) (Singapore)
  • Fellowship of the Academy of Medicine (Urology)
  • Clinical fellowship at Oxford Transplant Centre in the UK

Prior to entering private practice, Dr Lee served in the public sector for 16 years at SGH, where he initiated dedicated clinics evaluating and treating patients with complex men’s health and fertility issues. He also led the Renal Transplant Program and laparoscopic donor nephrectomy service as Surgical Director.

Apart from clinical work, Dr Lee is active in academia and believes in the importance of grooming the next generation of doctor. He was Senior Clinical Lecturer at NUS’ Yong Loo Lin School of Medicine and currently, Adjunct Assistant Professor at the Duke-NUS Medical School. Dr Lee is also regularly invited to share his experiences locally and regionally through lectures, workshops and surgical demonstrations.

Our Clinic Locations

Farrer Park Medical Centre, #08-05
1 Farrer Park Station Rd, Singapore 217562

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

3 Mount Elizabeth, #11-16 Medical Centre, Singapore 228510

Mon – Fri: 8:30am to 5:30pm
Sat: 8:30am to 12:30pm

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    Frequently Asked Questions

    Who needs TURBT?

    TURBT is recommended for individuals diagnosed with early-stage bladder cancer, especially when the cancer has not invaded the muscle wall of the bladder.

    How is TURBT performed?

    The procedure involves inserting a resectoscope through the urethra to the bladder. This instrument has a telescope for viewing and a wire loop to remove tumours. It usually takes about an hour and is often an outpatient procedure.

    Is TURBT painful?

    Patients are under anaesthesia during the procedure, so they don’t feel pain. Post-operatively, there may be some discomfort, pain, or stinging, especially during urination.

    What is the recovery time for TURBT?

    Recovery varies but generally includes a few days of rest post-procedure. A catheter may be placed for 1 to 3 days to assist in urination. Normal activity can usually be resumed within a week, though strenuous activity should be avoided.

    Will I need additional treatments after TURBT?

    Depending on the stage and nature of the bladder cancer, additional treatments like chemotherapy or a second TURBT might be necessary.

    How often should I follow up after TURBT?

    Regular follow-ups are necessary, especially since bladder cancer can recur. The frequency of follow-up visits will depend on the individual case.