Transurethral Resection of Bladder Tumor (TURBT) is a critical procedure in the management of bladder cancer. It serves both diagnostic and therapeutic purposes, allowing for the removal of bladder tumors as well as obtaining tissue samples for pathological examination.

Procedure Overview:

1. Preparation: The patient is usually given general or spinal anesthesia to ensure they are comfortable and pain-free during the procedure.

2. Cystoscope Insertion: A cystoscope, which is a thin, semi-rigid/flexible tube equipped with a camera and light, is inserted through the urethra into the bladder and all the areas of urethra and bladder is visualised.

3. Tumor Resection: Using specialized surgical instruments called resectoscope with resectoscopic sheath that can pass through the urethra, the Urologist, carefully resects (cuts away) the bladder tumor. The resected tissue is then sent to a laboratory for pathological analysis.

4. Hemostasis: After the tumor is removed, the urologist uses electric current (fulguration) or other methods to stop any bleeding and to destroy any remaining cancerous cells around the tumor site.

5. Completion: The procedure is completed, and the cystoscope is removed. The patient is typically monitored in the recovery area until the effects of the anesthesia wear off.

Post-Procedure Care:

• Hospital Stay: Some patients may be discharged on the same day, while others may need to stay overnight depending on the extent of the surgery and overall health.

• Catheterization: A urinary catheter may be placed temporarily to help drain the bladder and reduce irritation after the procedure.

• Follow-up: Regular cystoscopies are necessary to monitor for recurrence, as bladder cancer has a high recurrence rate.

• Intravesical Therapy: In some cases, intravesical chemotherapy or immunotherapy (e.g., BCG treatment) may be administered

Indications:

• Visible bladder tumors

• Hematuria (blood in urine) where bladder cancer is suspected

• Biopsy for diagnosis of suspected bladder cancer

• Staging of bladder cancer

Complications:

• Bleeding

• Infection

• Bladder perforation (rare)

• Urinary symptoms such as frequency, urgency, or dysuria (painful urination)

TURBT is a cornerstone in bladder cancer management and often serves as the initial step in a comprehensive treatment plan that may include further surgeries, radiation therapy, or systemic treatments depending on the cancer stage and grade.

Dr. Saurabh Mishra, as a leading urologist, has always emphasised the importance of Cystoscopy and TURBT in the early detection and management of bladder cancer. He emphasises how this procedure is critical not only for removing visible tumors but also for obtaining accurate pathological information that helps in staging the cancer, which is essential for determining the most appropriate treatment strategy.

Dr. Mishra might also highlight the role of TURBT in reducing the tumor burden and how, in some cases, it can be curative for non-muscle-invasive bladder cancer. Additionally, he would likely stress the need for meticulous technique during the procedure to minimize complications and ensure complete resection of the tumor, thus reducing the risk of recurrence.

Dr. Mishra advocates the patients for regular follow-up cystoscopies post-TURBT to monitor for any signs of recurrence, which is a critical aspect of ongoing bladder cancer management.

Trans-urethral resection of Bladder Tumor (TURBT)