Trans Urethral Resection of Bladder Tumor (TURBT) cost in Morocco

Statistical reports gathered in the year 2013 shows more than 10,000 individuals diagnosed with bladder cancer in the United States. Among them, successful results were obtained from the individuals who were diagnosed in the early stages and treated with TURBT. The treatment offers a reliable and successful approach. However, in some cases, the malignant tumor may only get removed after repeated TURBT treatment. This is because, a number of cases have shown recurrence of tumors post TUR. 

What is Trans Urethral Resection of Bladder Tumor (TURBT)?

Trans Urethral Resection of Bladder Tumor Treatment (TURBT) is one of the advanced procedures for treating tumors in the primary stage. Mostly in case of malignant tumors, TURBT offers a satisfactory solution and provides ample time for further treatments. Implementing TURBT in the initial stage, not only removes the tumor but also prevents the tumor from spreading to the nearby majority organs. The procedure is executed by inserting fine tube through the urethra which then travels to the target position and removes the tumor in the initial stages. 

Symptoms of Patient Undergoing TURBT Treatment

The patient undergoing a TURBT procedure may have to stay for a minimum of one to two days. However, one may require one to two weeks of bed rest, during which the individual may experience certain symotoms like: 

  • Asymptomatic hyponatremia
  • Changes in the ECG, 
  • Fatigue
  • Nausea
  • Vomiting
  • Loss of appetite
  • Confusion
  • Visual impairment 

Factors Affecting the Cost of TURBT

In general, a traditional TURBT treatment cost may vary from a minimum of $3000 to a maximum of $6000. However, the prices may vary due to some key factors, on which the procedure depends: 

  • The country where the procedure is being performed
  • The extent of number of procedures required
  • Underlying health conditions, if any
  • Type of healthcare facility availed
  • Proficiency and experience of the surgeons involved.
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About the Trans Urethral Resection of Bladder Tumor (TURBT)

Cancer in Bladder can be found to vary depending on the type of its origins. It can arise from the lining of the epithelium which is the inner lining of the urinary bladder or the urothelium. Rare forms of cancer are not of epithelial origins like the sarcoma or lymphoma. Tumours in bladder is found to be the 9th leading type of cancer in United States as per a survey conducted in 2012 with 430,000 new cases and mortality of 165000 deaths annually.

About Trans Urethral Resection of Bladder Tumor

The first and foremost question to ask is where is your bladder located? The sac like muscular urinary bladder is located in the pelvis region above the pelvic bone. It is connected to the kidneys through the two ureters that transfer the urine from the kidney to the bladder for storage. An abnormal growth of cells in the inner lining causes a tumour requiring diagnosis and then followed by a turbt surgery.

In most cases the tumour cannot be assessed in the primary stages. There are hardly any notable evidences found when the patient is harbouring a primary tumour.

The next stage is designated as Oa and categorized as a non invasive type papillary cancer.
In the stage next of the stage 0 or the carcinoma in situ the inner lining of the bladder is affected and is still considered non invasive.
In stage I the cancer has spread into the lining of the bladder further but has not affected the muscular wall of the bladder.
While in Stage II the inside part gets affected including the muscles of the bladder making it now invasive.
And when the cancer has spread enough in muscles and the tissues around the bladder like the reproductive organs it is considered to be in stage III.
And in the final or stage IV the cancer will spread to the lymph nodes affecting the organs around it as well.

Causes of developing a tumour in bladder

The causes of tumour in bladder are not always very clear and well defined but it has been linked with smoking, chemical exposure and radiation or a parasitic infection. The abnormal cells undergo some mutation that allows them to multiply in a non orderly fashion and goes beyond control and they do not die thus giving rise to the tumour.

Symptoms of the TURBT

A person suffering from a tumour will experience mild sensation of burning and discomfort in the times of urination for quite a few days. The force of the urinary stream may also undergo significant changes which can be observed for a week to a fortnight. Usually there could be none of the symptoms and in certain cases all symptoms even if experienced may not lead to the conclusion that it is a bladder cancer. There can be blood or clots of blood in the urine along with a tendency of urinating too frequently. Tendency of urinating at night may be felt more but there can be general problems in urine passing. Associated along with this the patient can experience pain on either side of the body.

What is transurethral resection of bladder tumour?

This procedure aims at removing bladder tumours at an early stage by inserting a scope through the urethra leading to the bladder. In the TURBT procedure bladder cancer can be detected by the urologist and potentially allow the urologist to treat various other kinds of bladder related disorders. But 75% of the cancer of bladders that are detected are superficial in nature causing growth only on the surface of the walls of the bladder and does not get very deep. So this facilitates the surgeon to have the tumour removed at the bladder wall level causing no damage to the deeper layers of the organ. The information that is collected while executing the procedure will help the surgeons to decide the type of the abnormality of the tumour and the extent of the tumour. This later allows the urologist surgeons to decide whether further treatments will be required or not.

What are the alternatives for TURBT procedure?

Some of the other treatment alternatives for TURBT are being worked upon while some of them have tremendous side effects

Blue light fluorescent cystoscopy : Enhanced tumour visualization is possible and detection of tumour chances are increased by almost 20 to 25% with this method where an ultraviolet blue light is used. A dye is injected an hour prior to the procedure.

Adjuvant bladder cancer therapy: TURBT is not suitable for many who have high chances of suffering a recurrence within 12 months from the treatment. In this case adjuvant therapy is recommended. It includes intravesicle chemotherapy. Chemotherapy for bladder cancer includes giving medication to curb the abnormal growth of cells. But it also has its sets of side effects like experiencing irritation in bladder and loss of hair, nails and feeling debilitated for a very long period of time.

How is Trans Urethral Resection of Bladder Tumor (TURBT) performed?

  • The techniques of anaesthesia used are all suitable for TURBDT procedure. In case of spinal anaesthesia the patient stays awake and the surgery team can stay alert for any TUR Syndrome. This is a rare complication but cannot be ignored still. But for complex tumours the resection does not prefer spinal anesthesia as obturator reflex where a leg thrust which is very powerful can be felt. So if tumour location is not known general anaesthesia is preferable with endotracheal tube or LMA allowing surgeon the flexibility for long as well as short term paralysis.
  • For achieving proper positioning Mitchell slings and split leg spreader table attachments are employed. In the dorsal lithotomy position when a patient is positioned then care is taken to ensure that all the points of pressure are adequately padded and none of the joints are flexed beyond 90 degrees. Peroneal nerve injury has to be avoided as there are chances of the same during compression of the nerve on the lateral fibular head.
  • With betadine scrub, chlorhexidene or with any other antiseptic agent the area is cleaned, and then covered with sterile drapes. The wires and cords are positioned as per the convenience of the surgeon. On the abdomen of the patient a video monitor is positioned at a suitable height ensuring comfort during the procedure and prevents neck or head strain as much as possible.
  • The Iglesias type continuous flow resectoscope is preferred and it allows the surgeon to control both inflow and outflow which when controlled for proper equilibrium will ensure constant volume in the bladder and having the tumour fixed in position and also have the vision cleared when coming across bloody fields.
  • The bladder has to be prevented from being overfilled and has to be maintained at half the volume all throughout the resection procedure. For small and moderate tumours the attacked area should be directed towards the tumour’s stalk.  The stalk of the tumour is at times hidden by the fronds or papilla of the tumour. Due to this there can be brisk bleeding which is continuous until and unless the large blood vessels. If the stalk does not get identified easily some of the fronds must be trimmed and then the stalk can be addressed.
  • Next the normal bladder mucosa and stalk has to be resected around the stalk circumferentially. During the resection of larger tumours it is suitable to send the chips resected separately for the pathologist so that they can identify the muscle fibers to signify sufficient resection.  Stalk base biopsies which are deep in the muscosa are also good for identifying muscle specimen.
  • Hemostasis has to be achieved after complete resection of the tumour, the resection site bases are painted and the mucosa edge around the tumour can ensure hemostasis adequately.
  • By a highly vascular stalk the papillary tumour is attached to the bladder. In order to get near the stalk surgeon must chip at the tumour’s periphery. The surgery is all about finding the stalk fast and addressing it to control it. That can at least stop the bleeding. But at times due to the size of the tumour it becomes difficult to locate the stalk and the surgeon has to look for the stalk evidence patiently.
  • With the help of an Ellik evacuator the bladder has to be irrigated copiously and the chips must be evacuated. The site has to be monitored to detect any bleeding, and the chips have to be removed before they clog the catheter. The irrigation has to be stopped and any remaining chips should be allowed to settle at the bottom of the bladder. With the help of a loop it must be grasped and manually pulled out from the bladder and Ellik can be used till all the chips are removed.
  • A large bore catheter should be placed. While some surgeons use 3 -way irrigation, this must be avoided to prevent catheter clotting off causing bladder perforation. Manual irrigation can be ideally used to maintain free flow of fluid. Lasix dose is used to create physiologic 3-way irrigation and it can simultaneously treat hyponatremia after the resection.

Recovery from Trans Urethral Resection of Bladder Tumor (TURBT)

A catheter will be given to the patient while going home and nurses will instruct how to maintain it clean and use it as a drainage bag. How to remove the catheter will also be taught which is a very simple and easy step and has very little discomfort associated with it. Antibiotic can be used in the form of ointment around the tip of the catheter to reduce irritation. Usage of an overnight bag is very convenient since it can store the urine for a longer period of time. It happens that there may be some blood clots that may pass while urinating; this must not scare you as it is normal. Addition to the overnight bag while walking a leg bag can also be worn. But if you find persistent clotting and large clots or the catheter is found not draining urine any more you should inform your surgeon.

The total period of recovery is pretty long as 6 weeks and can be divided into two weeks and then the last 4 weeks. During the first 2 weeks the patient is expected to behave as leisurely as possible and do very light activities and sexual activity must be avoided during this period. Of course within the first week one should go and collect the biopsy report and adhere to the medications prescribed by the doctor. In the next 4 weeks the patient can slowly resume back normal activities with periodic checkups with the doctor to understand the health and chances of recurrence.

Pros and Cons

Pros

  • It is the first line treatment which can detect stage and do treatment of visible tumours.
  • It can control low risk lesions without cost incurrence and inefficiencies of the operating room

Cons

  • It is not effective for carcinoma in situ
  • Runs the chances of recurrence
  • Recovery period is long

Patient Stories

Frequently Asked Questions

What are the factors affecting the cost of Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco?

Trans Urethral Resection of Bladder Tumor (TURBT) package cost in Morocco has different inclusions and exclusions. The Trans Urethral Resection of Bladder Tumor (TURBT) package cost usually includes all the expenses related to pre and post surgery expenses of the patient. The treatment cost usually includes the expenses related to hospitalization, surgery, nursing, medicines, and anesthesia. There are many things that may increase the cost of Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco, including prolonged hospital stay and complications after the procedure.

Which are some of the best hospitals in Morocco for Trans Urethral Resection of Bladder Tumor (TURBT)t?

Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco is offered by multiple hospitals across the country. Some of the most renowned hospitals for Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco include the following:

  1. Clinique Internationale Marrakech
How many days does it take to recover post Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco?

Upon discharge from the hospital after Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco, the patients are advised to stay for about 14 days for recovery. This is important to ensure that the surgery was successful. During this time, control and follow-up tests take place to check for medical fitness.

Which are some of the other popular destinations for Trans Urethral Resection of Bladder Tumor (TURBT)?

While Morocco is considered to be one of the best destinations for Trans Urethral Resection of Bladder Tumor (TURBT) owing to the standard of Hospitals, and expertise of doctors; there are a select few destinations which provide comparable quality of healthcare for the procedure However, there are other countries as mentioned below that are popular for Trans Urethral Resection of Bladder Tumor (TURBT) as well:

CountryCost
IndiaUSD 2000
MalaysiaUSD 8000
PolandUSD 4500
ThailandUSD 6000
TunisiaUSD 6500
TurkeyUSD 4000
United Arab EmiratesUSD 11500
How much are the other expenses in Morocco apart from the cost of Trans Urethral Resection of Bladder Tumor (TURBT)?

Apart from the cost of Trans Urethral Resection of Bladder Tumor (TURBT), the patient is also required to pay additionally for daily meals and guest house accommodation. These charges starts from USD 50 per person.

Which are the best cities in Morocco for Trans Urethral Resection of Bladder Tumor (TURBT) Procedure?

Some of the cpopular cities in Morocco that offer Trans Urethral Resection of Bladder Tumor (TURBT) include the following:

  1. Marrakesh
  2. Casablanca
How many days does one have to spend in the hospital for Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco?

The average duration of stay at the hospital after Trans Urethral Resection of Bladder Tumor (TURBT) is about 2 days for proper care and monitoring. During the recovery, the patient is carefully monitored and control tests are performed to see that everything is okay. If required, physiotherapy sessions are also planned during recovery in hospital.

How many hospitals offer Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco?

There are more than 1 hospitals that offer Trans Urethral Resection of Bladder Tumor (TURBT) in Morocco. The above mentioned hospitals have the required infrastructure and a dedicated unit where patients can be treated. These hospitals comply with all the rules and regulations as dictated by the regulatory bodies and medical association in Morocco

FAQ's Related to Morocco

What healthcare accreditation standards are followed in Morocco?

The hospitals in Morocco are as good as the best hospitals in the world in every parameter and thus JCI accreditation has been given to many wonderful hospitals in Morocco. The topmost healthcare accreditation body in the world with long term experience, Joint Commission International has gold standard credibility in Morocco. Premier healthcare organisations are competing for an accreditation by Joint Commission International, the most sought after in the field. Any hospital in the world as in Morocco can be vouched to be the exceptional in patient care, organisation management and quality of service if JCI certified.

Which are the popular multispecialty hospitals in Morocco?

Let us look at the popular multispecialty hospitals in Morocco:

  1. Clinique Assalam, Tangier
  2. Cheikh Zaïd Hospital, Rabat
  3. Centre Hospitalier Universitaire Ibn Rochd, Casablanca
  4. Polyclinique CNSS, Tangier
  5. Cheikh Khalifa Ibn Zaid Hospital, Casablanca
  6. Atlas Polyclinic, Fes
  7. Clinique la Capitale, Rabat
  8. Clinique Les Nations Unies, Rabat
  9. Clinique Dar Salam, Casablanca
  10. Clinique Bennis, Tangier
  11. Clinique Internationale Marrakech
  12. Clinique Val Fleuri, Tangier and Kenitra
  13. Agdal Clinic, Rabat
  14. Clinique Jerrada, Casablanca

Latest equipments which are upgraded on a regular basis are present in the popular multispecialty hospitals in Morocco. There are many multispecialty hospitals and clinics in Morocco that are present in the cities of Fes, Marrakech, Casablanca, Tangier and Rabat. The healthcare ecosystem in Morocco which comprises of multispecialty hospitals and clinics is synonymous with the best in healthcare.

Why should I opt for treatment in Morocco?

A wide healthcare base exists in Morocco with hospitals like local, regional and university hospitals providing more advanced healthcare and clinics cover basic healthcare facilities. A medical tourist in Morocco would be able to procure world class medical treatment and enjoy a wonderful holiday, a good reason to go to the country. The technological advancements in hospitals and clinics infrastructure in Morocco is on a growth path because of the joint collaboration of the government and private sector. It is not just the short waiting times but the ease with which you can get your medical visa, travel and ensure hospital transfer that make Morocco a medical travel hotspot.

What is the quality of doctors in Morocco?

The doctors in Morocco are exceptionally good when it comes to treating all kinds of medical conditions and emergencies which gives a lot of confidence to any patient coming to Morocco for their medical treatment. It is the excellent education and long term experience of doctors and surgeons in Morocco that speaks to their skill in treating patients. The doctors in Morocco work well with newer technologies and are adept at learning new techniques as well. The soft skills of the doctors in Morocco are highly developed because of their exposure to international training programs and treatment of international patients.

When traveling to Morocco for medical treatment, what essential documents do I need to carry along?

The essential documents that you must carry along on your journey to Morocco are:

  1. Invitation Letter from hospital in Morocco
  2. Bank statement of atleast last six months
  3. Passport
  4. Sponsorship letter (if applicable)
  5. Visa
  6. Medical reports/records
  7. Itinerary
  8. Accommodation booking details
  9. Return air tickets

Please ensure that the documents support your international, local travel and transfer and are a testament to your ability to pay for your medical travel. The communication between your healthcare providers, the one in your home country and the one in Morocco should be absolutely definitive and detailed. If your documents are complete, then your medical travel to Morocco should be seamless and effortless.

What are the popular procedures available in Morocco?

The popular procedures being performed in the hospitals in Morocco are as follows:

  1. Kidney Stone Removal
  2. Cardiac Valve Replacement
  3. Breast Augmentation
  4. Liposuction
  5. Polycystic Ovarian Syndrome(PCOS)Treatment
  6. Anterior Cruciate Ligament (ACL) Reconstruction
  7. Meniscus Repair

In Morocco, it is cosmetic procedures like Liposuction and Breast Augmentation that are bringing in a lot of medical travellers to the country. The healthcare providers in Morocco are proving to be efficient and effective in their job especially so in the fields of Cardiology and Nephrology with procedures like Cardiac Valve Replacement and Kidney Stone Removal getting increasingly popular. There is a huge influx of patients that are coming to Morocco as overseas medical travellers to get treated for their Gynaecological issues.

Is it mandatory to take vaccinations before going to Morocco?

If you are traveling to Morocco for your medical treatment, you wish to be adequately prepared in the form of vaccinations, so it is not just mandatory but an intelligent decision to be vaccinated beforehand. We bring to you the recommended travel vaccinations (by CDC and WHO) that you must take well before boarding your flight to Morocco:

  1. Polio
  2. Hepatitis A
  3. Hepatitis B
  4. Tetanus
  5. Rabies
  6. Typhoid

It is advised that you consult with your doctor to ensure that you meet the required criteria of age and health conditions so as the right vaccine dosage and frequency can be determined for you. There are always certain routine vaccines that you must be up to date with at all times irrespective of when you have made your travel plans such as DPT, Flu and MMR as mentioned by CDC or Centers for Disease Control and Prevention and WHO or World Health Organisation.

What are the other facilities provided by hospitals in Morocco?

There are International patient centers in every multidisciplinary hospital in Morocco that coordinates your travel and treatment from start to finish. Here are the various facilities present in the hospitals in Morocco other than the core medical treatment.

  1. Choice of Accommodation and Meals
  2. Flight Booking
  3. Airport Transfer
  4. Pharmacy
  5. Physiotherapy
  6. Prayer rooms

In Morocco, it is the hospital administrative staff that helps you with the insurance coverage assessment and the payment procedure. The virtual consultation via mediums like calls, emails and video is a convenient way of conversing with your physician in the hospital in Morocco.

What are the major medical tourism destinations in Morocco?

Please find below some of the medical tourism destinations in Morocco:

  1. Casablanca
  2. Fez
  3. Marrakech
  4. Rabat
  5. Tangier
  6. Agadir

Both the private sector and the Government of Morocco are investing in upgrading the healthcare sector and the tourism infrastructure which is having a promising effect on the medical tourism sector in Morocco. In the competitive field of medical travel, Morocco holds a good position as it has been ranked 31 in the Medical Tourism Index 2020-21. Medical travel industry is well supported by good legislation enacted by Government of Morocco and the positive development of the right ecosystem.

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