What Is a Transurethral Bladder Resection?

Transurethral bladder resection is a type of surgery performed on people suspected of having bladder cancer. This procedure involves the use of a small camera and surgical instruments that are passed into the bladder through the urethra, the tube that carries urine out of the body. These instruments are used to take samples of bladder tissue to diagnose bladder cancer. Cancerous lesions in the bladder can be removed as part of the procedure.

The bladder sits in the lower abdomen and serves to collect urine from the kidneys. When full, the bladder empties via the urethra. The first signs of bladder cancer may be difficulty urinating or blood in the urine. For people suffering these symptoms, a physician performs a physical exam and may check the urine for cancer cells. If the physician suspects that the patient may have bladder cancer, he or she may schedule the patient for a transurethral bladder resection.

Bladder cancer can appear as abnormal areas on the inside surface of the bladder. If these lesions are low grade and are still within the surface layer of epithelium, they can be removed. Cancer of the bladder that has invaded the muscle layer or that has metastasized to other organs may not be treatable with transurethral bladder resection.

To perform a transurethral bladder resection, the physician may choose to put the patient under general anesthesia or to use a regional anesthetic administered in the area around the bladder. A hollow tube containing a cystoscope, which is a lighted camera, is first passed up the urethra and into the bladder. The bladder must then be expanded with liquid to make the inside surface more visible. A resectoscope is then passed into the bladder through the hollow tube.

The resectoscope is a heated wire loop that is used to scrape away lesions on the inside surface of the bladder. Excess tissue is then flushed out of the bladder, pieces of which will be sent to a pathologist to confirm a diagnosis of bladder cancer. Care must be taken not to puncture the bladder during this procedure. Surface lesions can be removed during the transurethral bladder resection, but any cancerous lesions that have invaded the muscle must be treated with more extensive surgery.

At the end of the procedure, the physician will place a catheter in the urethra to drain urine out of the bladder. Patients should expect to spend one to four days in the hospital after a transurethral bladder resection. There may also be some blood in the urine as the inside of the bladder heals. It may take three to four weeks before the patient can return to any strenuous activity. Bladder cancer may recur, so it is important for the patient to be monitored by a physician at regular intervals.