A Comprehensive Guide to Trans Urethral Resection of Bladder Tumor (TURBT) Treatment

Transurethral resection of bladder tumor (TURBT) is a procedure utilized by Surgeons for both diagnosing and treating bladder cancer simultaneously.

During TURBT, a Surgeon employs a slender tool equipped with a camera, known as a cystoscope, to locate the tumor within the bladder and excise it. The removed tumor is then sent to a laboratory for examination by a pathologist. This analysis aids in determining the tumor's stage, indicating how deeply it has infiltrated the bladder wall, as well as its grade, which reflects the degree of abnormality in its cells compared to normal cells.

TURBT does not require any incisions; instead, the cystoscope is inserted through the urethra, the tube through which urine exits the body, to access the bladder.

Causes of tumor in the bladder

The causes of tumors in the bladder are not clear and well defined but it has been linked to smoking, chemical exposure to radiation, or a parasitic infection. The abnormal cells undergo some mutation that allows them to multiply nonorderly, which goes beyond control and does not die, thus giving rise to the tumor.

Classification:

Tumor Stage Classification: Tumors are staged based on how far they have grown into the layers of the bladder wall. The most commonly used staging system for bladder cancer is the TNM system, which stands for Tumor, Node, and Metastasis. The tumor stage is classified as follows:

Ta: Non-invasive papillary carcinoma
Tis: Carcinoma in situ (CIS)
T1: Tumor invades the subepithelial connective tissue
T2: Tumor invades the muscularis propria
T3: Tumor invades the perivesical tissue
T4: Tumor invades any of the following: prostate, uterus, vagina, pelvic wall, or abdominal wall.

Blood in the urine (hematuria) may appear pink, red, or cola-colored.
Frequent urination Individuals urinate more often than usual or experience a sudden urge to urinate.
Painful urination pain or discomfort during urination, which can range from mild to severe.
Bladder cancer can obstruct the flow of urine, leading to difficulty starting or maintaining urination.

Before undergoing a Transurethral Resection of Bladder Tumor (TURBT), the Following diagnostic tests are performed to assess the extent of the bladder tumor and plan the procedure effectively it includes:

Cystoscopy: it is a procedure where a thin, flexible tube with a camera (cystoscope) is inserted into the urethra and advanced into the bladder. This allows the healthcare provider to directly visualize the bladder lining and identify any abnormalities, such as tumors or areas of inflammation.

Imaging Studies: it includes ultrasound, MRI, and CT scans to evaluate the bladder and the surrounding structures.

Biopsy: It involves the removal of a small sample of tissue from the bladder tumor for examination under a microscope. It confirms the diagnosis of bladder cancer and determines the tumor grade.

Urinalysis: It may be performed to evaluate the urine for the presence of blood, abnormal cells, or other signs of urinary tract abnormalities.

Urine Cytology: It involves examining a sample of urine under a microscope to look for abnormal cells shed from the bladder lining.

Post-transurethral resection of Bladder Tumor (TURBT) involves immediate monitoring in the recovery room, pain management, and hydration. Upon discharge, patients are advised to rest, manage pain with prescribed medication, and maintain adequate hydration at home.

Follow-up appointments are essential for monitoring progress, managing urinary symptoms such as hematuria and bladder spasms, and gradually resuming normal activities, including work and sexual activity, as guided by healthcare providers.