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

Treatment and Cost

14

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2 No. Travelers

2 Day in Hospital

12 Days Outside Hospital

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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 Singapore?

Trans Urethral Resection of Bladder Tumor (TURBT) package cost in Singapore has different inclusions and exclusions. The top hospitals for Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore covers all the expenses related to the pre-surgery investigations of the candidate. The Trans Urethral Resection of Bladder Tumor (TURBT) cost in Singapore includes the cost of anesthesia, medicines, hospitalization and the surgeon's fee. A prolonged hospital stay due to delayed recovery, new diagnosis and complications after surgery may increase the cost of Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore.

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

There are many hospitals across the country that offer Trans Urethral Resection of Bladder Tumor (TURBT) to international patients. Some of the best hospitals for Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore include the following:

  1. Farrer Park Hospital
How many days does it take to recover post Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore?

The recovery of the patient many vary, depending on several factors. However, on an average, patient is supposed to stay for about 14 days in the country after discharge. This duration of stay is recommended to complete all the necessary follow-ups and control tests to ensure that the surgery was successful.

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

Singapore is one of the most popular countries for Trans Urethral Resection of Bladder Tumor (TURBT) in the world. The country offers the best cost of Trans Urethral Resection of Bladder Tumor (TURBT), best doctors, and advanced hospital infrastructure. Some of the other popular destinations for Trans Urethral Resection of Bladder Tumor (TURBT) include the following:

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

Apart from the Trans Urethral Resection of Bladder Tumor (TURBT) cost, there are a few other daily charges that the patient may have to pay. These are the charges for daily meals and accommodation outside the hospital. The per day extra expenses in Singapore per person are about USD 50 per person.

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

The following are some of the best cities for Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore:

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

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. The patient is subjected to several biochemistry and radiological scans to see that everything is okay and the recovery is on track. After making sure that patient is clinically stable, discharge is planned.

What is the average rating of Hospitals in Singapore offering Trans Urethral Resection of Bladder Tumor (TURBT)?

The average rating for Trans Urethral Resection of Bladder Tumor (TURBT) hospitals in Singapore is 2.7. Several parameters such as hospital infrastructure, pricing policy, quality of services, politeness of staff etc. contribute to the rating.

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

There are more than 1 hospitals that offer Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore. These hospitals have propoer infrastructure as well as offer good quality of services when it comes to Trans Urethral Resection of Bladder Tumor (TURBT) Apart from good services, the hospitals are known to follow all standard and legal guidelines as dictated by the local medical affairs body or organization.

Who are the best doctors for Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore?

Some of the best doctors for Trans Urethral Resection of Bladder Tumor (TURBT) in Singapore are:

  1. Dr. Ronny Tan Ban Wei
  2. Dr. Sam Peh Oon Hui
  3. Dr. Jimmy Beng
  4. Dr. Png Keng Siang
  5. Dr. Chong Kian Tai
  6. Dr. Lewis Liew

FAQ's Related to Singapore

What healthcare accreditation standards are followed in Singapore?

The accredition of hospitals in Singapore is done by Joint Commission International as an international accredition agency. Healthcare quality and patient safety parameters are assessed by the Joint Commission International or JCI. The Organisation management of top hospitals of Singapore is checked by Joint Commission International and is a sign of the healthcare providers commitment to providing quality healthcare. The most stringent international standards are followed by the JCI or Joint Commission International in order to give hospitals in Singapore the accredition.

Which are the popular multispecialty hospital groups in Singapore?

The popular multi specialty hospital groups in Singapore are as follows

  1. Mount Elizabeth Hospital
  2. Raffles Hospital
  3. National University Hospital
  4. Gleneagles Hospital
  5. Singapore General Hospital
  6. Changi General Hospital
  7. Johns Hopkins Singapore International Medical Centre
  8. Tan Tock Seng Hospital
  9. Parkway Hospitals Singapore

The high standards of medical care provided by the popular multispecialty hospitals in Singapore ensures that a truly international patient population frequents them. The popular multispecialty hospitals in Singapore are known for their high quality of medical professionals in a wide variety of specialties. It is the really short waiting duration to get the best of medical treatment that makes Singapore multispecialty hospitals your best bet.

Why should I opt for healthcare in Singapore?

Do opt to get healthcare in Singapore because of the highly developed infrastructure which is vouched for by one and all. The comprehensive care and high precision of outcomes is the standard set by the healthcare professionals and healthcare providers in Singapore. The fact that Singapore healthcare system is synonymous with high degree of commitment to provide service to their patients is the reason one must opt for healthcare in Singapore. Singapore is a medical tourism hub because it has high degree of access to quality healthcare for all and seamless travel opportunities.

What is the quality of doctors in Singapore?

It is important to know that with immense practical knowledge in their specialisation and being thorough professionals, doctors in Singapore are among the chosen few. It can be safely concluded that Singapore has good quality of doctors on the basis of their focus on precision and efficiency of treatment. As Singapore is a major international medical tourism destination, the doctors in Singapore have great international exposure which ensures that the quality of doctors in Singapore is very high. The doctors in Singapore are educated from the best universities of the world and have acquired great skill in treating patients.

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

We bring to you the list of documents needed for your medical travel to Singapore:

  1. Medical Records and Reports describing your medical condition
  2. Communication from the hospital and/or the doctor that has referred you
  3. Passport
  4. Treatment Plan and Frequency of treatment
  5. Fit to travel confirmation
  6. To and Fro travel tickets
  7. Visa relevant to your visit as a medical traveller to Singapore
  8. Proof of financial means for travel and treatment
  9. Credit Card/Debit Card/Valid internet banking account in Singapore

Please create the document checklist before starting your journey to Singapore as a medical traveller. The documents that you need to carry for your medical treatment to Singapore will be consisting of your financial standing, your travel related documents and the ones that are related to your medical condition. It is essential to make sure that your travel documents align with your medical travel visa requirements making your treatment, stay and travel back a seamless process.

What are the popular procedures available in Singapore?

We are outlining here the most popular procedures done in Singapore:

  1. Dentistry
  2. Orthopedics
  3. Cardiology
  4. Cosmetic/Plastic Surgery
  5. Ophthalmology

Cardiology procedures have long been the forte of healthcare providers in Singapore owing to their expertise stemming from the best of education and training in performing these procedures. Cardiology procedures have long been the forte of healthcare providers in Singapore owing to their expertise stemming from the best of education and training in performing these procedures. Singapore is a hub for cosmetic surgery procedures such as:

  1. Liposuction
  2. Rhinoplasty
  3. Face Lift
  4. Breast Augmentation
  5. Blepharoplasty
What are the other facilities provided by hospitals in Singapore?

The major hospitals in Singapore ensure that the stay is comfortable not just for the patient but even the people accompanying them by providing a number of additional facilities. Hospitals in Singapore are constantly putting efforts in making your travel and transfer seamless by providing you facilities such as:

  1. Accommodation
  2. Flight Booking
  3. Airport Transfers
  4. Interpreter

It is pertinent to note that hospitals in Singapore are always seeking to make your medical travel to Singapore easy by enabling private payment gateways and the wide availability of private insurance. Patient centric care is ensured by the hospitals in Singapore in the form of health screening programmes, dietitians and pharmacies.

What is the procedure for obtaining medical visa for Singapore?

It is important that you check the visa requirements for your country as Singapore is a country with relaxed visa norms for many countries. Let us have a look at the required documents for medical visa for Singapore:

  1. Passport with the required time validity
  2. Completed application form
  3. LOI or Letter of Introduction from a local contact in Singapore
  4. A recent passport size photograph
  5. Bio data page photocopy of the passport of the applicant
  6. Covering letter and forwarding letter

It is good to note that it takes a minimum of five working days for the processing of your medical visa (exceptions maybe additional time during peak periods and due to incomplete visa applications). Do check the required visa fee from your country for Singapore medical visa. Please make sure that you submit your original bank statement with your visa application to get your Singapore medical visa.

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