Transurethral Resection of Bladder Tumor

Transurethral resection of a bladder tumor is the removal (resection) of a cancerous growth (tumor) on the inside wall of the bladder. The bladder is the organ that holds urine. The tumor is removed through the tube that carries urine out of the body (urethra).

In a transurethral resection, a thin telescope with a light, a tiny camera, and an electric cutting edge (resectoscope) is passed through the urethra. In men, the opening of the urethra is at the end of the penis. In women, it is just above the vaginal opening.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Any recent urinary tract infections you have had.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs, such as:
  • The urethra.
  • The tubes that drain urine from the kidneys into the bladder (ureters).
• Pain and burning during urination.
• Difficulty urinating due to partial blockage of the urethra.
• Inability to urinate (urinary retention).

What happens before the procedure?

• Follow instructions from your health care provider about eating and drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may have a physical exam.
• You may have tests, including:
  • Blood tests.
  • Urine tests.
  • Electrocardiogram (ECG). This test measures the electrical activity of the heart.
• You may be given antibiotic medicine to help prevent infection.
• Ask your health care provider how your surgical site will be marked or identified.
• Plan to have someone take you home after the procedure.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• Your legs will be placed in foot rests (stirrups) so that your legs are apart and your knees are bent.
• The resectoscope will be passed through your urethra and into your bladder.
• The part of your bladder that is affected by the tumor will be resected using the cutting edge of the resectoscope.
• The resectoscope will be removed.
• A thin, flexible tube (catheter) will be passed through your urethra and into your bladder. The catheter will drain urine into a bag outside of your body.
  • Fluid may be passed through the catheter to keep the catheter open.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You may continue to receive fluids and medicines through an IV tube.
• You will have some pain. Pain medicine will be available to help you.
• You will have a catheter draining your urine.
  • You will have blood in your urine. Your catheter may be kept in until your urine is clear.
  • Your urinary drainage will be monitored. If necessary, your bladder may be rinsed out (irrigated) by passing fluid through your catheter.
• You will be encouraged to walk around as soon as possible.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do not drive for 24 hours if you received a sedative.

Transurethral Resection of Bladder Tumor, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• A small amount of blood in your urine for up to 2 weeks.
• Soreness or mild discomfort from your catheter. After your catheter is removed, you may have mild soreness, especially when urinating.
• Pain in your lower abdomen.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a sedative.
• If you were prescribed antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do not lift anything that is heavier than 10 lb (4.5 kg) for as long as told by your health care provider.
• Avoid intense physical activity for as long as told by your health care provider.
• Walk at least one time every day. This helps to prevent blood clots. You may increase your physical activity gradually as you start to feel better.

General instructions

• Do not drink alcohol for as long as told by your health care provider. This is especially important if you are taking prescription pain medicines.
• Do not take baths, swim, or use a hot tub until your health care provider approves.
• If you have a catheter, follow instructions from your health care provider about caring for your catheter and your drainage bag.
• Drink enough fluid to keep your urine clear or pale yellow.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have pain that gets worse or does not improve with medicine.
• You have blood in your urine for more than 2 weeks.
• You have cloudy or bad-smelling urine.
• You become constipated. Signs of constipation may include having:
  • Fewer than three bowel movements in a week.
  • Difficulty having a bowel movement.
  • Stools that are dry, hard, or larger than normal.
• You have a fever.

Get help right away if:

• You have:
  • Severe pain.
  • Bright-red blood in your urine.
  • Blood clots in your urine.
  • A lot of blood in your urine.
• Your catheter has been removed and you are not able to urinate.
• You have a catheter in place and the catheter is not draining urine.