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Transurethral Bladder Tumor Removal

For early stage or superficial bladder cancers, a transurethral resection (TUR), also known as a transurethral resection of the bladder tumor (TURBT), is the most common treatment. This surgery is done through an instrument passed up the urethra, so it does not require cutting into the abdomen. You will get either general anesthesia (where you are asleep) or regional anesthesia (where the lower part of your body is numbed). For this operation, a type of rigid cystoscope called a resectoscope is placed into the bladder through the urethra. The resectoscope has a wire loop at its end to remove any abnormal tissues or tumors. The removed tissue is sent to a lab to be looked at by a pathologist. Most patients have superficial cancer when they are first diagnosed, so this is usually the first treatment they receive. When bladder cancer is invasive, and cannot be removed by means of a transurethral resection, all or part of the bladder may need to be removed. This operation is called a cystectomy.
 

When you get home:

Diet

You may return to your normal diet immediately. Because of the raw surface, alcohol, spicy foods and drinks with caffeine may cause some irritation or frequency and should be used in moderation. To keep your urine flowing freely and to avoid constipation, drink plenty of fluids during the day (8-10 glasses).

Activity

Your physical activity is to be decreased especially during the first two weeks after surgery. During this time, use the following guidelines:
  • No lifting heavy objects (anything greater than 10-15 lbs.)
  • No driving for about 10-14 days
  • No strenuous exercise for 2 weeks
  • No sexual intercourse for 2 weeks
  • No severe straining during bowel movements - take a laxative if necessary
  • You may walk as much as you want. You may use stairs, but be careful
  • You may shower or take baths unless instructed not to do so

Medication

You should resume your Pre-surgery medications unless told not to. You should avoid aspirin, ibuprofen, Naprosyn, etc (Tylenol is okay) for the next 2 weeks or so until any bleeding subsides and some healing has occurred. In addition, you may be given an antibiotic to prevent infection and possibly stool softeners if indicated. These should be taken as prescribed until the bottles are finished unless you are having an unusual reaction to one of the medications. You may also be given some narcotic pain medication. Take this as indicated and discontinue this when you no longer feel you need them.

Side Effects:

Bowels

It is important to keep your bowels regular during the postoperative period. A bowel movement every other day is reasonable. Use stool softeners (i.e. Colace, Senekot, Fibercon, etc.) if needed. Take a mild laxative if needed and call if you are having problems (Milk of Magnesia 2-3 tbsp. or 2 Dulcolax tablets for example).
Problems you should report to us:
  • Fevers over 101.3 Fahrenheit
  • Heavy bleeding or clots (see notes above about blood in urine)
  • Inability to urinate
  • Drug reactions (hives, rash, nausea, vomiting, diarrhea, etc.)
  • Severe burning or pain with urination that is not improving

Follow Up:

Your recent bladder/urethral surgery requires very special post hospital care. Despite the fact that no skin incisions were used, the area in the bladder/urethra is quite raw. This will usually resolve over a period of weeks. You may see blood in your urine over the next 4-6 weeks. Do not be alarmed, even if the urine was clear for a while. If this occurs, decrease your activity and increase the amount of your fluid intake until the urine clears. You will need a follow-up appointment to monitor your progress. Call for this appointment at one of our office numbers above when you get home or from the phone in your hospital room before leaving. Usually, the first appointment will be about 7-14 days after your surgery.