Tumour is removal or resection of
the urinary bladder tumour with
the help of an endoscopic cutting
device that is inserted into your
urinary bladder via your urethra.
approach vs. Open approach - What is the
Transurethral Resection of Bladder
Tumour - This procedure is usually
performed when the tumour is confined
to a section of the bladder.
Cystoscopic removal of Bladder Tumour
- In this method, the bladder tumour
(small) is removed with a Cystoscope
same as a stone is removed from
Partial Cystectomy - The bladder
is approached through an incision
in the abdomen and the tumour is
containing part of the bladder is
Complete, Radical or Total Cystectomy
- This surgery is performed when
the tumour is large and has advanced
(muscle invasive bladder cancer)
to involve the surrounding structures
like the ureters, urethra, vagina
and the uterus (in women) and in
men it may involve the prostate
gland and the seminal vesicles.
While performing a Total Cystectomy
in men, the nerve bundles that are
responsible for urinary incontinence,
erection and orgasm may be cut inadvertently.
Cystectomy is a better option in
case of advanced bladder cancer
to ensure complete removal of the
cancer. Following Total Cystectomy,
reconstruction of bladder is performed
from the bowel tissue.
What is the
carcinogen profile of bladder cancer?
- The most important
is tobacco smoking.
- Chronic (low
grade) and recurrent urinary tract infection.
hazard - people working with materials
like dyestuffs, rubber compounds, leather,
print and petroleum
- Excessive use
of phenacetin containing drugs
infection of the bladder caused by a worm
called Schistosoma Hematobium.
Who is an
ideal candidate for T.U.R.-Bladder Tumour?
you have a cancerous or non-cancerous growth
of the urinary bladder, that is small and
is confined to the urinary bladder and has
not spread to the surrounding structures,
then you are an ideal candidate for T.U.R.-Bladder
do I prepare for T.U.R.-Bladder Tumour?
blood and urine analysis, CT of abdomen
and chest x-ray will be requested by your
physician on your pre-oparative consult.
Inform your physician about your other health
conditions and medications (including all
the prescription, non-prescription medications,
nutritional supplements i.e. vitamins, minerals
and herbal products). Refrain from taking
aspirin or Ibuprofen at least 2 weeks before
T.U.R.-Bladder Tumour. Stop smoking a few
weeks before T.U.R.-Bladder Tumour to prevent
healing problems during recovery period.
Do not eat or drink anything for at least
10 hours before the T.U.R.-Bladder Tumour
surgery. You will be instructed to be hospitalized
the night before the surgery.
does the procedure for T.U.R.-Bladder Tumour
Tumour is performed under general anesthesia
or spinal block with sedation. A Cystoscope
is inserted via the urethra up into the
bladder. The bladder is filled with fluid
so that it is easily visualized from inside.
The prostate gland is examined, a surgical
loop is inserted through the Cystoscope
to remove the portion of the enlarged prostate.
A catheter is left in the bladder to allow
for urine to flow easily for several days
after the procedure. The entire procedure
of T.U.R.-Bladder Tumour may take about
is the recovery period like following T.U.R.-Bladder
will spend the next couple of hours in the
recovery room under observation following
T.U.R.-Bladder Tumour. Your vital signs,
circulation and respiration will be closely
monitored. You will also be closely monitored
for any immediate post-operative complications
like excessive bleeding. A foley's catheter
will be retained in your urinary bladder
to drain urine which may be blood tinged
or may contain clots. You will experience
some pain and discomfort which can be alleviated
by the use of pain medication. Keep the
operation area clean, avoid heavy lifting
and sexual activity for 3 - 4 weeks. You
will be able to get back to your normal
activities in 4 - 6 weeks time following
is the outcome of T.U.R.-Bladder Tumour?
outcome of T.U.R.-Bladder Tumour depends
on the type of tumour which is determined
on histopathological examination of the
tissue. In case of transitional cell carcinoma
of bladder, it is not uncommon for the tumour
to appear at another site i.e. the kidney
or ureters. The procedure of T.U.R.-Bladder
Tumour is quite successful in removing localized
of T.U.R.-Bladder Tumour
Tumour is considered to be a minimally invasive
procedure and can be a treatment of choice
for patients who are at high medical risk
for anesthesia or a major operation such
as Radical Cystectomy. This method of treatment
has reduced risk of damage to the nerve
bundles during the surgery resulting in
incontinence or impotence neither should
it effect in your sex drive.
of T.U.R.-Bladder Tumour
- Infection (Urinary
- Excessive bleeding
- Blood clots in
- Perforation of
urethra or urinary bladder
- Impotence (rare)
- Infertility (rare)
to T.U.R.-Bladder Tumour
- Partial or Total Cystectomy is the treatment
of choice if the bladder tumour cannot be
accessed through the transurethral route
or if the cancer is advanced and has spread
to the surrounding tissues.
treatment - In Intravesicular therapy
procedure, liquid medicine is inserted directly
into the bladder with a catheter. The advantage
of Intravesicular Therapy is that it acts
locally on the bladder cancer and minimizes
the side effects that accompany systemic
use of therapeutic drugs.
- This treatment option is effective in
especially in advanced or metastatic bladder
therapy - External-beam irradiation
is sometimes used as a palliative measure.
- Bacille Calmette-Guerin or BCG consists
of live, attenuated bacteria that are effective
in stimulating the immune system to kill
of the Procedure
specialized cystoscope (a thin, lighted
tube used to examine the bladder) is inserted
into the urethra via the penis and up into
the bladder. The bladder is filled with
a solution, so that the surgeon can better
see its interior. The prostate gland is
examined through the scope. The surgeon
inserts a surgical loop through the cystoscope
to remove the portion of the prostate that
has become enlarged. A catheter is left
in the bladder to allow for urine flow for
several days after the procedure, and may
also be used to flush the bladder to remove
accumulated blood clots.
tissue is sent to a lab and analyzed
Long Will It Take?
several days after the surgery, you may
feel some pain. The catheter may cause some
Syndrome (occurs in about 2 percent of patients,
usually within the first 24 hours); symptoms
Increase or decrease in blood pressure
Bradycardia (slow heart action) or abnormal
Tachypnea (increased rate of respiration)
Nausea or vomiting
Coma and shock in serious case
Thrombophlebitis (blood clots in the
Average Hospital Stay: 2–5 days
will be a catheter in your bladder to
drain urine. The urine may be bloody,
but do not be alarmed. This is normal.
Water may be flushed through the catheter
into your bladder to wash out blood
Always keep the catheter drainage bag
below the level of your bladder.
Do breathing and coughing exercises
Rest in bed until the next morning and
perhaps longer. The nurse can assist
you the first time you get out of bed.
Clean the area where the catheter enters
the urethra several times a day with
soap, water, and a washcloth.
Drink lots of fluids, especially during
the day, to help flush your bladder.
Avoid heavy lifting or exertion for
three to four weeks.
Avoid sexual activity for four to six
weeks after surgery.
Avoid consumption of alcohol, caffeine,
and spicy foods that may over-stimulate
from surgery should take about three weeks.
Symptoms such as frequent or painful urination
will continue for a while but should lessen
during the first six weeks. If there is
blood in your urine, lie down, relax, and
drink a glass or two of fluid. The next
time you urinate the bleeding should have
stopped. If it doesn't, call your doctor.
activity should be avoided for four to
six weeks after surgery, the TURP procedure
should not affect your sex drive or ability
to have sex. The procedure may damage
the muscle valve located at the bladder
that directs semen into the urethra and
out the penis. If this happens, most of
your sperm will flow into your bladder
and be expelled when you urinate (this
is called retrograde ejaculation). This
should not, however, be considered a method
of birth control. Some sperm may make
it into ejaculation. If you are hoping
to conceive children in the future, talk
to your doctor about the possibility of
developing retrograde ejaculation after
to "Urology Surgery"