How is bladder tumor surgery performed using a minimally invasive (laparoscopic) method?

Transurethral resection of bladder tumor (TURBT) is a minimally invasive surgical procedure in which bladder tumors are removed through the urethra. This technique allows the tumor to be excised without the need for open surgery and helps shorten the patient’s recovery time. TURBT is used for both diagnosis and treatment in early-stage bladder cancer.

What is Turnover Surgery (TURBT)?

Transurethral Resection of Bladder Tumors (TURBT) is a surgical procedure used in the diagnosis and treatment of bladder cancer. In this method, the surgeon removes the tumor from the bladder by inserting a thin tube (cystoscope) and special surgical instruments through the urethra. No external incisions are made during the procedure.

TURBT (Transurethral Resection of the Bladder) is performed for both diagnostic and therapeutic purposes. The removed tumor is sent to a laboratory for examination by a pathologist. This examination helps determine how far the tumor has spread to the bladder wall (its stage) and how different the cells are from normal tissue (its degree).

Following the procedure, patients may experience mild pain or discomfort, usually lasting one to two weeks. Due to its minimally invasive nature, TURBT is an effective treatment method for bladder tumors.

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How is bladder tumor surgery performed using a minimally invasive (laparoscopic) method?

Before a TURBT procedure, the patient is usually given general anesthesia, which puts them to sleep. In some cases, spinal (regional) anesthesia is preferred. With this method, the patient is awake, but the lower part of the body is completely numb.

In some patients, a special dye is injected into the bladder to make the tumor clearer. This dye is administered via a catheter placed in the urethra approximately one hour before surgery. During surgery, a special light is used to activate the dye, allowing for better definition of the tumor's boundaries.

During TURBT surgery, the surgeon inserts a thin endoscope into the bladder through the urethra. This instrument visualizes the tumor, which is then removed using a small cutting instrument. The removed tissue is examined in a pathology laboratory. Heat is applied to stop any bleeding that may occur after the tumor is removed.

If necessary, a catheter is inserted at the end of the procedure. The catheter allows urine and other fluids to drain from the bladder and prevents blood clots from forming. In some cases, the bladder is washed with sterile saline solution. Not every patient requires a catheter.

No pain is felt during the TURBT procedure. However, after the surgery, mild pain or burning sensation may occur, especially when urinating, which can last from a few days to a week.

What are the benefits of minimally invasive bladder tumor surgery?

The most important advantage of TURBT is that it allows for both biopsy and treatment of tumors that have not spread outside the bladder. This method reduces the number of procedures by eliminating the need for additional surgeries. It also minimizes the risk of complications that may arise from each additional intervention.

The benefits of laparoscopic bladder tumor surgery are listed below:

• Both the biopsy and the treatment are performed simultaneously.
• No further surgery will be required.
• The risk of complications is reduced.

What complications can occur after laparoscopic bladder tumor surgery?

After bladder tumor surgery, some complications may develop, including bleeding, infection, urinary incontinence, urinary tract narrowing, and sexual dysfunction. The specialist physician will inform the patient about these possibilities.

How long does laparoscopic bladder tumor surgery take?

Transurethral Resection of Bladder Tumors (TURBT) typically takes between 30 minutes and 1 hour. However, the duration of the surgery can vary depending on factors such as the size, number, and location of the tumors in the bladder.

The procedure is performed under general or spinal anesthesia. Most patients are discharged the same day or the next day after surgery. The operation time may be extended if unexpected complications develop during surgery, such as bleeding or damage to the tissues surrounding the bladder.

What precautions should be taken after bladder tumor surgery?

Drinking plenty of fluids in the post-bladder cancer surgery period helps cleanse the urinary tract and reduce the risk of infection. The diet should prioritize fiber-rich foods and fresh fruits and vegetables.

Physical activity should begin with light walking, and strenuous exercise should be avoided until the healing process is complete. Smoking must be stopped as it increases the risk of bladder cancer recurrence.

Cystoscopy is performed within the first three months after TURBT surgery. After that, follow-up examinations are conducted at intervals of three to six months, depending on the patient's risk factors.

Things to keep in mind after bladder tumor surgery:

• Take the medications prescribed by your doctor regularly.
• Drink plenty of fluids and consume fiber-rich foods.
• Tell your doctor if you experience pain or difficulty urinating.
• Don't miss your check-up appointments.

Most patients return to normal lives after bladder cancer surgery. However, problems such as urinary incontinence, sexual dysfunction, or decreased bladder capacity may occur. These conditions can usually be controlled with treatment.

Which medical specialty handles bladder tumor surgery?

Bladder tumor surgery (TURBT) is performed within the field of Urology. In bladder cancer treatment, the physician who diagnoses, performs surgical procedures, and monitors the patient is called a urologist.

Frequently Asked Questions About Laparoscopic Bladder Tumor Surgery

Below are frequently asked questions and answers about TURBT surgery.

What happens if a bladder tumor is not removed?

If a bladder tumor is not removed, cancer cells can spread by metastasizing through the bladder wall to lymph nodes and distant organs.

Can a bladder tumor reappear after it has been removed?

The risk of recurrence is high after bladder tumor removal, especially in non-muscle invasive types; regular follow-up and intravesical chemotherapy are used to try to prevent recurrence.

Do bladder tumors spread rapidly?

The rate at which bladder tumors spread varies depending on their stage. Invasive types carry a risk of rapid metastasis to lymph nodes and distant organs, penetrating the bladder muscle layer.

How long does recovery take after bladder surgery?

TURBT procedure usually takes a few weeks, while radical cystectomy takes several months.

How to urinate after bladder removal?

After the bladder is removed, urination can be performed through a normal urethral opening using an artificial bladder created from the intestine.

How long does it take to get the pathology results for a bladder tumor?

Pathology results after a bladder tumor biopsy are usually available within 3-7 days.

Where can a bladder tumor metastasize?

Bladder tumors commonly metastasize to pelvic lymph nodes, bones, lungs, and liver.

Is it safe to have sexual intercourse after bladder surgery?

Sexual intercourse can be resumed after complete recovery from bladder surgery (usually 4-6 weeks).