A procedure called transurethral resection of a bladder tumor (TURBT) is frequently used to help diagnose bladder cancer, as well as being a common part of bladder cancer treatment.1
The procedure is sometimes called transurethral resection (TUR) and it is generally performed by a urologist, which is a doctor who specializes in bladder cancer and other health aspects related to the urinary tract.
A cystoscopy can reveal abnormal cells
If a patient has symptoms and urine test results that suggest the presence of bladder cancer, then a healthcare provider will typically request a test called cystoscopy to examine the inside of the bladder for any signs of bladder cancer cells.1
If the cystoscopy reveals that there are areas of abnormal cells inside the bladder that might be cancer cells, then a biopsy needs to be used to examine the cells more closely. A biopsy involves taking a very small sample of tissue from the bladder to be analyzed in the laboratory. The TURBT procedure can be used to take the biopsy that is needed to make a definite diagnosis of bladder cancer.
Taking a biopsy during a TURBT procedure
When it is used to help diagnose bladder cancer, the TURBT procedure may involve taking small tissue samples from the area with abnormal cells or removing all of the tissue that contains abnormal cells. The urologist may also take samples from other parts of the bladder lining to check for cancer cells.
The biopsied tissue is then sent to the lab where it is analyzed to see if it contains cancer cells. Small samples of muscle from the walls of the bladder near the area of abnormal cells may also be taken for analysis, to see if it contains cancer cells that have grown into the muscle.
A TURBT can remove early stage cancer
The TURBT procedure is also a very common treatment for bladder cancer that is at an early stage or is non-muscle invasive, which means the bladder tumor or tumors are only located in the thin layer of cells that line the bladder walls (the urothelium) and have not grown into the muscles of the bladder walls.2,3
How does a TURBT work?
When the TURBT procedure is used to treat non-muscle invasive bladder cancer tumors, the urologist tries to completely remove the tumor and destroy any cancer cells in the bladder. The urologist may also use high-energy electricity or a high-energy laser beam to destroy the base of the tumor and try to eliminate any cancer cells that may remain in the area.
Sometimes urologists will recommend administration of a chemotherapy drug injected directly into the bladder to help kill any remaining cancer cells and try to reduce the likelihood that cancer cells will grow again. This is called intravesical chemotherapy treatment. Some patients may need another TURBT procedure a few weeks or months later as part of their treatment.
Is a person under anesthesia during a TURBT?
The TURBT procedure is performed in a hospital by a urologist while the patient is under anesthesia, which may be general (patient is unconscious throughout the procedure) or regional (patient is conscious, but the lower part of the patient’s body is numb).4
Some people are able to go home later the same day as the procedure, but others may need to stay in the hospital overnight.
What happens during the TURBT procedure?
During TURBT, the urologist uses a resectoscope—similar in shape to the cystoscope instrument used in the cystoscopy procedure—to pass a tiny wire loop into the bladder through the urethra. The urethra is the hollow, tube-like organ that allows urine to flow out of the body from the bladder. The tiny wire loop can be used by the urologist to remove any tumors or areas of abnormal cells.
Tissues that are removed from the bladder (biopsies) are sent to the lab so that the cells can be analyzed. The base of the tumor, and any remaining cancer cells, may be treated with an electric current or laser to make sure the tumor has been treated completely. Based on the results of the biopsy, urologists may recommend any necessary follow-up treatments.