Trans-Urethral Resection of a Bladder Tumor (TURBT)
Transcription
Trans-Urethral Resection of a Bladder Tumor (TURBT)
The Bladder Cancer Advocacy Network presents... Tips From Patients, For Patients: Trans-Urethral Resection of a Bladder Tumor (TURBT) Generally, after the diagnosis of a bladder tumor, the urologist will suggest that the patient have an outpatient procedure in the hospital to examine the bladder more completely under anesthesia (general or spinal) and to remove, if possible, those tumors which are suitable for removal. The doctor may refer to this procedure as a TURBT (transurethral resection of a bladder tumor). The TURBT is “incision-less” surgery usually performed in the hospital as an outpatient procedure, but some patients may need to stay overnight because of their medical conditions or the extent of the tumor resection. The TURBT is the first-line surgical treatment for bladder tumors. Like the cystoscope, the instrument used to remove the tumor is put in the bladder through the urethra. (The urethra is the tube that carries urine from the bladder out of the body.) Attached to this scope is a small, electrified loop of wire which is moved back and forth through the tumor to cut and remove the tissue. The tissue is then examined by a pathologist to determine the stage and grade of the bladder cancer. In some patients, immediately after a TURBT, the doctor may instill an intravesical chemotherapy drug directly into the bladder, which can reduce the chances of future tumor recurrences. Mitomycin C (MMC) is a common drug used for this purpose. BCAN surveyed bladder cancer patients to find out what they thought patients should know about three key areas related to TURBT. These tips are their thoughts and advice. What Questions Should Patients Ask Their Doctor About Getting a TURBT? 1. Why is getting a TURBT a good option for me? • What is the goal of the TURBT? Will I need another one? • What will the results of the TURBT tell you? 2. What will happen after the TURBT? • What kind of anesthesia will you be using? • How long does the procedure take? After it is over, when will I be able to go home? • Will you give me an intravesical treatment such as Mitomycin C (MMC) after the TURBT? • How long will it take for me to recover after the TURBT? How long will I need a catheter? What side effects can I expect, and what should I look out for? Can you give me any medications before I go home to help with potential side effects? • When will you know the results of the pathology report? Will you call me, or should I call you? • What further treatments might I need? 3. What is your experience with this treatment? • Are you experienced with TURBTs? Do you treat a lot of bladder cancer patients? • Where can I go to get a second opinion? www.bcan.org | info@bcan.org | 888-901-BCAN Made possible by a grant from What are the Most Important Things Patients Should Know About Getting a TURBT? 1. Preparing for the TURBT… • Try to relax and remain calm before the procedure. Positive thinking really helps. • Bring a friend or family member to take notes on what the doctor tells you and to give you a ride home after the procedure. • Know whether you will be placed under general anesthesia (in which you are completely unconscious) or a local anesthesia (where just the lower half of your body is numbed). Depending on the anesthesia, you might need to fast before the procedure. 2. After the TURBT… • You may be sent home with a catheter. Make sure you understand how to use it and when it should be removed. • It can take just a few days or as many as a few weeks to feel completely like “yourself ” again. • Side effects of the TURBT vary, and may include painful urination, bladder irritation, frequency, and bladder spasms. Medications and soothing gels can help; ask your doctor what they recommend. • Blood in your urine and passing blood clots (from the scabs where they took out the tumors) can continue for a few weeks. • A pathologist will look at the tumors to determine the stage and grade of the bladder cancer. The pathology report usually comes back in 1-2 weeks. Your doctor will help you decide what additional treatment you might need based on what the pathology report says. What are your Top Tips for Coping with a TURBT? 1. Take care of yourself! • Try to schedule the appointment at a time that’s convenient for you. Some people prefer to schedule appointments early in the week so they can reach the doctor if they have problems; others prefer to schedule appointments on Fridays so they can rest over the weekend. 2. Plan ahead for what might help after the treatment. • Pads or protective underwear can help people who experience incontinence after the treatment. • You might want to rest for a few days after the treatment. • Follow your doctor’s instructions. Get instructions in writing so you can refer to them later. Call your medical team if you have questions or something seems wrong. 3. Be aware of what might happen next. • You may need to have a repeat TURBT in 2-6 weeks to completely remove the tumor or to get a deeper biopsy sample for the pathologist to examine. • If you have small, low-grade tumors that have not invaded the most superficial lining of the bladder, this might be the only treatment you need. You’ll still need regular cystoscopies to make sure there is no recurrence. • If your tumors are higher-grade but still have not invaded the bladder muscle’s wall, your doctor might recommend intravesical BCG. See the Patient Tipsheet on BCG for more information. • If the tumor has invaded the muscle wall, your doctor may recommend a surgery to remove your bladder. Sometimes, other treatment may be needed along with this type of surgery. See the Patient Tipsheet on Radical Cystectomy for more information. BCAN provides this information as a service. Publication of this information is not intended to take the place of medical care or the advice of your doctor. BCAN strongly suggests consulting your doctor or other health professional about the information presented. www.bcan.org | info@bcan.org | 888-901-BCAN Made possible by www.bcan.org | info@bcan.org | 888-901-BCAN a grant from
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