TURBT

What is TURBT?

TURBT is a procedure to remove a growth, polyp, or tumor from the bladder’s inner lining. A thin tube with a camera and cutting tool passes through the urethra, the tube that carries urine out of the body, without any cuts on the skin or abdomen.

The removed tissue goes to a pathologist for close examination. This helps determine if the growth is cancerous, how abnormal the cells look and how likely they are to behave aggressively, known as the grade, and how far it extends into the bladder wall, stage and depth. These details guide the next steps in care.

Professor Jack Baniel explains bladder cancer and its treatment. Watch the short video below.

How bladder tumors are found

Blood in the urine is a common sign that leads to checks for bladder tumors. It may be visible to the eye or only show up in a lab test, and it often appears without pain.

Doctors typically use imaging, ultrasound and sometimes CT, to look at the kidneys, ureters, and bladder, and cystoscopy, a thin camera passed through the urethra, to inspect the bladder lining directly.

If cystoscopy reveals a polyp or tumor, TURBT is usually the next step. It removes visible tissue and allows a precise diagnosis.

Why TURBT is done

Diagnosis and staging

TURBT provides tissue samples for lab analysis. This confirms whether cells are cancerous and assesses their grade, how abnormal the cells look and how likely they are to behave aggressively, and stage, how deeply they’ve grown. Early tumors stay in the inner lining; deeper ones reach the bladder muscle. These findings shape the care plan.

Initial treatment

For tumors limited to the bladder’s surface, non muscle invasive, TURBT often removes all visible growths as the main treatment. Muscle invasive tumors, which grow deeper, may need more involved care after TURBT confirms the extent. Depending on pathology results, some patients may receive added bladder treatments to help prevent return.

What happens during TURBT

Before the operation, on the day

You arrive at the hospital, often as day surgery, as instructed. Staff confirm your details, review medications and allergies, and start an IV line for fluids or medicines. The anesthetist explains options: general anesthesia, fully asleep, or spinal anesthesia, numb from the waist down while awake.

Practices can vary by center, so follow your team’s specific guidance.

During the operation

With anesthesia in place, the surgeon inserts a scope, camera and instruments, through the urethra into the bladder. Fluid fills the bladder for a clear view of the lining. A wire loop on the scope cuts away the tumor in small pieces, including some underlying tissue for staging. Bleeding spots are sealed with heat from the tool.

A catheter may be placed at the end to drain urine. Some teams use saline irrigation through it to clear clots. The procedure length depends on tumor size and number.

After TURBT

Recovery starts in a monitoring area. Urine may look pink or red with small clots initially, fading over hours or days. Pain relief and bladder spasm medicines help as needed.

The catheter often stays briefly; staff test your ability to urinate before removal. Discharge home may occur the same day or after one night, depending on your health and procedure details.

Treatments inside the bladder after TURBT, instillations

Some patients with non muscle invasive tumors may be offered intravesical therapy, medicines placed directly into the bladder via catheter, to lower recurrence risk. Suitability depends on pathology, tumor features, and your overall risk group.

Intravesical chemotherapy may include medicines such as mitomycin to target remaining cells in the lining. The solution is kept in the bladder for a set time, often around an hour, depending on local protocol, then drains when you urinate. It is mainly intended to act on the bladder lining, which may reduce whole body side effects compared with some systemic treatments.

BCG immunotherapy uses a weakened bacteria preparation placed into the bladder. It prompts immune cells to attack abnormal areas. It is designed to act locally, but rare serious side effects can occur. In rare cases it can cause significant side effects; your team will advise what to watch for. Courses typically run weekly for weeks, with possible maintenance; your team decides based on results.

Not everyone needs this. Discuss options with your urologist.

Follow up cystoscopies

Bladder tumors, especially surface level ones, may return, so regular checks matter. Your plan includes repeat cystoscopies to scan the lining for new growths.

Intervals vary and are set by risk category and clinician plan; in higher risk cases, cystoscopy is often done every few months at first, then less often if clear. If changes appear, early TURBT can address them.

Risks and when to seek help

Common, usually short term effects

• Pink or bloody urine for days
• Burning or stinging when urinating
• Frequent or urgent need to urinate
• Mild pelvic or lower belly discomfort
• Fatigue from anesthesia

Less common but important complications

• Bladder or urinary infection, may include fever
• Heavier bleeding or clots needing extra care
• Trouble urinating after catheter removal
• Bladder wall perforation, small hole often managed with catheter drainage and observation, but occasionally needs further treatment
• Urethral narrowing over time

This information is general and does not replace medical advice from your care team.