TURBT in Sharjah

What is TURBT?

TURBT, short for transurethral resection of bladder tumour, is the first operation for almost every bladder growth. A slim telescope called a resectoscope is passed along the urethra into the bladder, and a fine wire loop carrying an electrical current shaves the tumour away from the bladder wall while sealing small vessels.

TURBT does two jobs at once. It removes the visible tumour, and it provides the tissue that tells your team exactly what the growth is. The surgeon deliberately takes a thin layer of the muscle beneath the tumour as well, because the pathologist needs to see that muscle to judge how deeply the growth reaches. That depth, called the stage, together with how abnormal the cells look, called the grade, decides everything that follows.

At Dar Al Kamal Hospital, Sharjah, TURBT is carried out by the specialist urologist as part of the pathway described on the bladder cancer treatment page.

Who needs it

TURBT is recommended when a growth is seen in the bladder, usually during a cystoscopy done to investigate blood in the urine, or when a scan shows a mass in the bladder wall. It is also used when follow-up cystoscopy finds a new growth in someone treated before, and sometimes as a planned second resection a few weeks after the first to check the base of the tumour thoroughly.

For a bladder growth, TURBT is the standard starting point, because the laboratory result it provides shapes every later decision. Growths confined to the lining are often treated by TURBT alone, followed by regular checks and sometimes medicine placed directly into the bladder. Growths that have reached the muscle layer lead to a discussion of larger treatment, such as radical cystectomy or combined therapies. Your urologist explains the plan once the result is back, and the decisions that follow are made with you.

What happens

Before surgery a CT scan of the kidneys, ureters and bladder is usually arranged, because the lining of the upper urinary tract can occasionally be affected too.

TURBT is done under spinal anaesthesia, which numbs you from the waist down, or under general anaesthesia. You lie on your back with your legs supported, and the resectoscope enters through the urethra, so there is no wound on the skin. Sterile fluid fills the bladder to open it out. The surgeon examines the whole lining, notes the size, number and position of any growths, and then removes each one in small strips. Samples from the base and from any other suspicious patch go to the laboratory in separate labelled pots.

After the resection, a single dose of medicine is sometimes placed into the bladder through a catheter and held there for a short time. This dose aims to stop loose tumour cells from settling elsewhere on the lining. A catheter then drains the bladder, and some patients have fluid washed through it until the urine clears.

Preparing for it

A pre-operative assessment checks your heart, lungs, blood count and kidney function, and a urine test confirms there is no infection. Bring a full list of your medicines; blood thinners and anti-platelet tablets need a specific plan from your doctor, and you receive fasting instructions for the day.

If you smoke, stopping now is one of the most useful steps you can take, because tobacco chemicals pass through the urine and bathe the bladder lining. Write down questions for the results appointment, and bring a family member if you would like support. If surgery falls near Ramadan, raise it early so fasting and medicines can be planned together.

Afterwards

Blood in the urine, stinging and a frequent urge to pass urine are normal early on and settle as the bladder lining heals. Drink steadily through the day so the urine stays pale; in the Sharjah heat you will need more than you expect. Avoid heavy lifting and straining, and keep your bowel motions soft.

The laboratory result is usually discussed at a follow-up appointment at Dar Al Kamal Hospital, Sharjah, where your urologist explains the stage and grade and the next step. For many people that step is a schedule of check cystoscopies, starting a few months after TURBT, because the bladder lining can form new growths over time. Keeping every appointment is the most important part of aftercare.

Contact the hospital urgently if you pass clots, if the urine stays dark red despite drinking more, or if you develop a fever or worsening pain. **Go to the emergency department straight away if you cannot pass urine at all and your lower abdomen is swollen and painful.**

Cost and insurance

Most UAE insurance plans cover TURBT as a cancer or suspected-cancer procedure, with pre-approval required, supported by the cystoscopy findings and scan report. The histology, any medicine placed into the bladder, and each follow-up cystoscopy may need their own approval, and a second resection is usually approved separately. Dar Al Kamal Hospital, Sharjah can help you check your cover and start the approval early on 06 599 7777.