T.U.R.B.T. (Trans-Urethral Resection of Bladder Tumour)

The Procedure

In clinic, the doctor explained that your symptoms are caused by one, or more, lesions (lumps) in your bladder. The operation you require involves the removal of the lesions from within your bladder, so they can be sent to the laboratory to be analysed.

An instrument is passed through your urethra (water passage) into the bladder in order to remove the tissue in small pieces. Fluid is passed through the instrument during the procedure to enable the surgeon to have a clear view when performing the procedure.

Before your operation

You will be having either a general or a spinal anaesthetic, so you will have a pre-screening appointment to assess your suitability for day surgery, before you are given a date for your operation. At this appointment the nurse will take details of your:

• medical history
• current medication
• home care arrangements after you have been discharged from hospital.
• You must have somebody to collect you from hospital and somebody with you 24 hours after your surgery.

Please use this opportunity to ask any questions about your surgery and after-care. Where possible, the nurse will arrange a mutually convenient date for your surgery. S/he will also give you instructions about preparing for your operation, which will include advice about:

• having a bath or shower before you come to the hospital
• eating and drinking
• taking your normal medication, if appropriate

• Returning to work after surgery

You may be booked in to stay overnight on the unit, ready for early discharge the following day. If the surgeon feels it is prudent, you may be allowed home on the evening of your surgery.

On the day of your surgery

You should have a bath or shower before you come to hospital.

If you normally wear contact lenses, you will need to remove these before your operation. Please bring your spectacles or an extra pair of contact lenses with you.

On admission to the unit you will be greeted by a nurse who will check that your details are correct. The surgeon and the anaesthetist will talk to you and you will be invited to ask any questions you may have. A member of staff will escort you, as you walk if you are able to, to the operating theatre.

Following your operation

You will be transferred to the ward area where nurses will continue to monitor your condition.

Occasionally, patients may have to be transferred to the urology ward, following their operation. This is a precaution and the nursing staff will ensure that you and your relatives are kept fully informed should this be necessary.

At the end of the operation, the surgeon may insert a catheter, which is a small bore tube, through the urethra into the bladder. This will allow fluid to be continuously dripped into your bladder to ensure blood does not collect and clot, which could cause an obstruction. Depending on the colour of the urine draining from the bladder, the catheter may be:

• Removed before discharge
• Removed the following morning
• Left in, when you go home

The nursing staff will ensure you are fully prepared, if you have to be discharged home with a catheter. The catheter will need to stay in for at least 2 days and then you will return to the Day Unit or to the urology department, where the catheter will be removed and a check made to ensure that you are able to pass urine satisfactorily.

If you feel any discomfort, please inform the nurse looking after you, so that pain relief can be given.

You will need to have something to eat and drink, before you can go home.

Care at home

You may feel some discomfort when you pass urine for the next 12 to 24 hours. Your urine may also be slightly bloodstained. If you drink plenty of fluid, any discomfort or
discolouration should decrease with time.

You may need up to two weeks off work and should not do any heavy lifting for 7 to 10 days.

Following this procedure you will have to return to the hospital for further bladder inspections on a regular basis, so that the surgeon can ensure the lesions do not occur.

Possible complications

Minor

• Bladder infection
• Moderately Severe
• Inability to pass urine after surgery
• Damage to the urethra (urinary opening) or surrounding skin

Major

• Significant blood loss

Please contact The Surgical Assessment Unit (SAU): 0113 206 9256, if you:

• Develop a temperature
• Pass fresh blood or clots
• Are unable to pass urine*
• Have prolonged or severe pain

* If necessary, you should attend the Accident & Emergency department at your local hospital.

If you have any problems or cause for concern please contact: