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

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.
Treatment and Cost

14

Total Days
In Country

2 No. Travelers

2 Day in Hospital

12 Days Outside Hospital

Treatment cost starts from

USD 9000

Hospitals

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

How much does Trans Urethral Resection of Bladder Tumor (TURBT) cost in Tunisia?

USD 6500 is the starting cost of Trans Urethral Resection of Bladder Tumor (TURBT) Surgery in Tunisia. While there are wide range of hospitals offering Trans Urethral Resection of Bladder Tumor (TURBT), international patients should always seek TEMOS-Certified Hospitals in Tunisia for the best results.

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

Different hospitals have different pricing policy when it comes to the cost of Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia. 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. Extended hospital stay, complications after the surgery or new diagnosis may affect the overall cost of Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia.

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

There are several best hospitals for Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia. Some of the best hospitals for Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia include the following:

  1. Taoufik Clinique
  2. Le Centre International Carthage Medical
  3. Hannibal International Clinic
How many days does it take to recover post Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia?

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 period is important to conduct all the follow-up tests to ensure that the surgery was successful and the patient can go back to the home country.

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

While Tunisia 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 Tunisia apart from the cost of Trans Urethral Resection of Bladder Tumor (TURBT)?

Apart from the Trans Urethral Resection of Bladder Tumor (TURBT) cost, the patient may have to pay for additional daily expenses such as for guest house after discharge and meals. The extra charges may start from USD 50 per person.

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

Some of the best cities in Tunisia which offer Trans Urethral Resection of Bladder Tumor (TURBT) are:

  1. Marsa
  2. Tunis
  3. Soukra
  4. Carthage
  5. El Manzah
How many days does one have to spend in the hospital for Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia?

The patient has to spend about 2 days in the hospital after Trans Urethral Resection of Bladder Tumor (TURBT) for proper recovery and to get clearance for discharge. 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.

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

There are more than 3 hospitals that offer Trans Urethral Resection of Bladder Tumor (TURBT) in Tunisia. The above mentioned hospitals have the required infrastructure and a dedicated unit where patients can be treated. Such hospitals follow all legal protocols and guidelines as specified by the local medical affairs body when it comes to the treatment of international patients.

FAQ's Related to Tunisia

Which are the popular multispecialty hospitals in Tunisia?

We have outlined the most popular multispecialty hospitals in Tunisia for your reference:

  1. Hannibal International Clinic, Tunis
  2. Cinic Soukra, Soukra
  3. La Centre International Carthage Medical, Monastir
  4. Clinic Alyssa, Tunis
  5. Taoufik Clinique, El Menzah
  6. Eureka Esthetique, Marsa
  7. Polyclinique L'Excellence, Mahdia
  8. Clinique Avicenne, Tunis
  9. Taoufik Hospital Group
  10. Clinique De L`espoir, Tunis
  11. Ennasr Clinic, Ariana
  12. El Manar Clinic, Tunis
  13. Polyclinique les Jasmins, Tunis
  14. Pasteur Clinic, Tunis
  15. La Clinique Mediterraneenne, Tunis

The outstanding levels of quality and a personal touch in service delivery to patients is the hallmark of the popular multispecialty hospitals in Tunisia. The multispecialty hospitals in Tunisia diagnose conditions, even complex health conditions and treat them with finesse and efficiency. The cutting edge infrastructure of the healthcare institutions in Tunisia is a good reason for you to opt for healthcare in Tunisia.

Why should I opt for healthcare in Tunisia?

The advanced healthcare infrastructure in the hospitals and clinics in Tunisia makes for a pretty good reason for you to get your healthcare in the country. You must choose to get your healthcare from Tunisia as the hospitals and clinics here are composed of really qualified and skilled medical, paramedical and administrative professionals. A 360* approach from consultation to post treatment rehabilitation or follow ups, short waiting times and competitive costs make Tunisia the right choice for you to get your healthcare from. The healthcare system in Tunisia is conscious of keeping high levels of cleanliness and as a medical traveler to Tunisia you are bound to feel absolutely safe and secure.

What is the quality of doctors in Tunisia?

The practical training and long term experience of doctors in Tunisia enables them to work well under pressure for long hours which translates to great results. The doctors in Tunisia strive to learn throughout their career; therefore, they are highly educated and continue to upgrade their knowledge and qualifications as they practise medicine and treat patients successfully. As a patient, you feel confident in your doctor in Tunisia as they are known to be good managers; they have to liaison with fellow doctors, other healthcare professionals, hospital personnel and leading teams when performing procedures successfully. The doctors in Tunisia are great at leading medical, surgical teams and are experienced in liaising with doctors and healthcare professionals giving you the confidence as a patient that you are in good hands.

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

Do carry with you the important documents that are required for your medical travel to Tunisia; we have outlined them for you:

  1. Visa
  2. Passport
  3. Credit Card/Debit Card/Net Banking
  4. Sufficient finances to cover your expenses
  5. Medical Reports
  6. Referral from hospital from country of origin recommending your treatment
  7. Return flight tickets
  8. Accommodation proof

The documents that are important for you to carry to Tunisia must be representative of your itinerary and your medical treatment. The Government of Tunisia is making an effort to make sure that your medical travel to Tunisia is made easier. It is introducing the online visa application for Tunisia where your short term visit for medical tourism is preceded with a hassle free visa process. An essential document for your medical travel to Tunisia, the medical visa would now be easier to get with the introduction of a more seamless online visa application process.

What are the popular procedures available in Tunisia?

We bring to you the popular procedures being performed in Tunisia.:

  1. Breast Cancer Treatment
  2. Fibroid Removal Surgery
  3. Knee Replacement
  4. Hip Replacement
  5. Spinal Fusion

Of the many popular procedures available in Tunisia, the Spine and Orthopaedic treatments are a big draw. Breast Cancer treatment is a strength of the oncologists in Tunisia and one of the main reasons for the increasing number of medical travellers heading to the country. The gynecological procedures such as fibroid removal surgery are done on a regular basis in Tunisia and is one among the various popular procedures regularly performed in the hospitals here.

Is it mandatory to take vaccinations before going to Tunisia?

It is mandatory to take vaccinations before going to Tunisia and we are listing the important ones here.

  1. Chickenpox
  2. Shingles
  3. Pneumonia
  4. Influenza
  5. Hepatitis A
  6. Hepatitis B
  7. Typhoid
  8. Rabies
  9. Meningitis
  10. Polio
  11. Measles Mumps and Rubella (MMR)
  12. TDAP (Tetanus, Diphtheria and Pertussis)
  13. Covid19

The CDC: The Centers for Disease Control and Prevention, the US agency and WHO: World Health Organisation, a UN body have suggested two kinds of vaccinations for your medical travel to Tunisia, the recommended travel and routine vaccines. There are certain vaccines which you must be up to date with at all times and then there are vaccines which are for specific health hazards and to be used conditionally such as for Hepatitis A, Hepatitis B, Typhoid and Rabies. It is always wise to get vaccinated before going on your medical travel to Tunisia whether recommended by any health agency or not.

What are the other facilities provided by hospitals in Tunisia?

It is the many additional facilities extended by the hospitals in Tunisia that make yourdecision to head to the country for medical travel easier. The hospitals in Tunisia give many additional facilities to the medical tourists as mentioned here for you:

  1. In house laboratories to run tests
  2. Language proficient interpreters
  3. Accommodation for patients and co-travellers
  4. International and local travel assistance
  5. Hospital transfers
  6. Pharmacies managed through computerized systems

We have outlined for you the various additional facilities that are there in the hospitals in Tunisia. The hospitals in Tunisia boast of extra facilities such as dietitians, physiotherapists and prayer rooms for the ones who believe in the power of prayer.

What are the major medical tourism destinations in Tunisia?

The potential of Tunisia as a world class medical tourism destination is because of the synergy of the tourist attractions in its many governorates with the outstanding healthcare infrastructure available. There are several good medical tourism hotspots in Tunisia and they are listed below:

  1. Tunis
  2. Monastir
  3. Bizerte
  4. Sousse
  5. Tabarka
  6. Sfax
  7. Gabes
  8. Jerba
  9. La Marsa

The Medical Tourism Index of 2020-21 puts Tunisia on the world map with a ranking of 38 among 46 nations. The healthy tourism industry, healthcare focus, excellent relationships of Tunisia with European union and Arab nations made this happen. The warm hospitality, easy visa norms, good healthcare at affordable prices together make Tunisia a major medical tourism destination.

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