Bladder tumour resection

What is this?

This procedure involves the telescopic removal of a bladder tumour with heat diathermy

What alternatives are there?

Open surgical removal of bladder, chemotherapy or radiation therapy.

What to expect before procedure

If you are taking Aspirin or Clopidogrel on a regular basis, you must discuss this with your urologist because these drugs can cause increased bleeding after surgery. There may be a balance of risk where stopping them will reduce the chances of bleeding but this can result in increased clotting, which may also carry a risk to your health. This will, therefore, need careful discussion with regard to risks and benefits. You will usually be admitted on the day before your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Either a full general anaesthetic (where you will be asleep throughout the procedure) or a spinal anaesthetic (where you are awake but unable to feel anything from the waist down) will be used. All methods minimise pain; your anaesthetist will explain the pros and cons of each type of anaesthetic to you. You will usually be given injectable antibiotics before the procedure, after checking for any allergies. A telescope is inserted into the bladder and the tumour removed bit by bit using heat diathermy or laser. The tumour fragments are evacuated using suction and sent for pathology analysis. A catheter is usually inserted after the procedure.

After the procedure

A catheter will normally be inserted into the bladder after this procedure. Before the catheter is removed, it is normal practice in most patients to instil a special blue chemical (Mitomycin C) which reduces the risks of subsequent tumour recurrence in the bladder. This is left in place for 1 hour, usually on the day of surgery. Once your urine is clear, the catheter will be removed. You will normally be allowed home once you have passed urine satisfactorily. The average hospital stay is 2-3 days.

Potential side effects