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Bleeding After Bladder Tumor Removal

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Turbt Recovery & Complications

Bladder Tumor Removal with TURBT – Urology Care Foundation

After the procedure, a flexible tube may be inserted into the bladder through the urethra to assist with draining urine from the bladder. The catheter will usually stay in place for 1 to 3 days. For a few days after the catheter is removed, the patient may have difficulty controlling their urine. This should improve on its own.

Although no incision is made in the belly, TURBT is still considered a major surgery. To speed up recovery, the patient should plan on resting for a few days after the procedure. This includes avoiding stressful physical activities.

Overexertion can cause bleeding inside the bladder. Some blood in the urine, however, is normal. If this does not clear up after several days, or if urination continues to be difficult or blood clots are present in the urine, a physician should be contacted immediately. It is also normal to notice a couple of days of bloody urine again 10 to 14 days after surgery.

Antibiotics may be prescribed to prevent infections, including those of the urinary tract. If so, it is important to take them as directed in order to prevent a recurrent infection.

Other complications of TURBT are:

  • Perforation of the bladder wall

What Happens After The Procedure

You may go home the same day as your surgery, or you may need to stay in the hospital for a few days. You will have a catheter, or tube, in the bladder to help drain urine and to flush out any remaining pieces of tumor and any blood clots that have formed. Your healthcare provider will remove the catheter when there is no more bleeding.

After the catheter is removed, you may have trouble controlling your bladder for a few days while you recover from the surgery.

Follow your healthcare providers instructions. Ask your provider:

  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Interim Analysis And Monitoring

Because this is a short-term study with a 2-year follow-up period, we will not conduct interim analysis. However, the safety of PDD-EBTUR will be independently evaluated by the Safety Monitoring Committee when:

  • i)

    A critical modification of the study protocol is required

  • ii)

    Any serious adverse event associated with this surgical procedure occurs

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    Antiplatelet Therapy And Bladder Tumor Resection


    It is not uncommon to see patients taking antiplatelet drugs for various indications who require surgery. Transurethral resection of bladder tumors involve removal of tumor in pieces while the blood supply to the tumor remain intact. Naturally, the risk of bleeding remains significant. Prader and colleagues have tried to address this important clinical issue. In a simple study, the authors have compared the bleeding complications of TURBT in patients receiving APDs with those patients who were not receiving these drugs . In the study period extending for about 2 years the authors retrospectively analyzed all 117 patients receiving APDs and 117 consecutive patients naive to APD who underwent TURBT.

    Rather than measuring blood loss by performing complex analysis like measuring the hemoglobin concentration in bladder irrigation fluid at time of surgery and in the post-operative period the authors have used the length of post-operative hospital stay as a simple and practical surrogate to study the impact of APDs. Instead of measuring statistical difference in the hospital stay between the two groups the authors calculated clinically significant difference in the length of hospital stay of more than 1 day.

    When Should I Seek Advice From My Physician

    Fibroids Cause Indigestion

    A patient should contact their physician if they run a 101 degree or greater fever or if they begin passing clots that are larger than 1 inch in diameter. Some will have cherry colored urine, but may also experience darker burgundy-colored urine and at times brown-colored urine. The color of urine typically is determined by how long a time has passed since the bleeding began. Drinking 48 ounces of water daily after TURBT can help avoid larger clots that may be problematic.

    Patient Portal

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    Bladder Cancer Research At Columbia

    Columbia University is a leading global institution in cancer care and research, helping to drive innovation, establish new treatments, and develop technologies that offer hope for patients everywhere.

    From precision medicine that targets a tumors unique biology to creating less invasive options, experts across Columbia are at the forefront of clinical trial research helping to build the next standard of carelife-saving procedures that also help maintain quality of life.

    Thanks to the Department of Urology at CUIMC and the Herbert Irving Comprehensive Cancer Center, research at Columbia is leading the way to a common goal: a cancer-free future.

    • Patients may be eligible if they: are 18+ years old
    • are available for in-office visits & treatments over 6-8 weeks at the trial location in NYC have a confirmed diagnosis of BCG refractory or recurrent non-muscle invasive urothelial carcinoma of the bladder are eligible for radical cystectomy, but refuse this treatment or are not a surgical candidate due to other comorbidities are not pregnant or lactating

    Featured Clinical Trial:

    The CGC Trial

    • Seeking patients with Stage 1 bladder cancer who have been unresponsive to BCG therapies for Phase 2 of
    • the CGC clinical trial.

    Are There Side Effects To A Turbt

    The most common side effects of the TURBT are bleeding, pain, and burning when urinating. These may be intermittent and can last for up to one month. If the bladder tumor is large, the urologist may choose to leave a catheter in the patients bladder for a day or two. This helps to minimize problems occurring from bleeding, clot formation in the bladder or expansion of the bladder due to possible storage of excess urine or blood. Even if the tumor is small, a catheter may be inserted to rinse the bladder out if the bleeding persists.

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    Bladder Cancer Clinical Trials

    Major drug companies continually research and develop new medications and treatments for bladder cancer that must be shown to be safe and effective before doctors can prescribe them to patients. Through clinical trials, researchers test the effects of new drugs on a group of volunteers who have bladder cancer. Following a strict protocol and using carefully controlled conditions, researchers evaluate the investigational drugs under development and measure the ability of the new drug to treat bladder cancer, its safety, and any possible side effects.

    Some patients are reluctant to take part in clinical trials for fear of getting no treatment at all. But patients who participate in clinical trials receive the most effective therapy currently available for the condition, or they may receive treatments that are being evaluated for future use. These bladder cancer drugs may be even more effective than current treatment. Comparing them in a clinical trial is the only way to find out.

    Hereâs where to find information about whether a bladder cancer clinical trial is right for you.

    This website lists industry-sponsored clinical trials that are actively recruiting patients.

    Show Sources

    American Cancer Society: âBladder Cancer Treatment,â âBladder Cancer Surgery,â âRadiation Therapy for Bladder Cancer,â âChemotherapy for bladder cancer,â âFDA Approves New Immunotherapy Drug for Bladder Cancer,â âImmunotherapy for bladder cancer.â

    Radical Cystectomy And Reconstructive Surgery

    Bladder cancer treatment: TURBT

    If the cancer has invaded the bladder wall or you have tumors in multiple locations within the bladder, you may need a radical cystectomy. Its a procedure to remove the bladder and nearby lymph nodes. Because theres a possibility the cancer has spread, other organs are removed as well.

    In women, this often means removing the:

    In men, it may mean removing the prostate and seminal vesicles.

    The procedure is done under general anesthesia and involves an abdominal incision. It can also be done laparoscopically with the aid of robotic instruments.

    Once your bladder and other organs are removed, your surgeon will create a new way for you to urinate. There are a few ways to do this:

    • Incontinent diversion: A piece of your intestine can be used to make a tube that runs directly from the ureters to a pouch outside your abdomen .
    • Continent diversion: A piece of intestine is used to make a pouch, which is connected to an opening in the skin on your abdomen. Using a catheter, you will drain the pouch several times a day. Theres no need to have a bag outside your body.
    • Neobladder: In this procedure, the surgeon makes a new bladder out of intestine. The neobladder is attached to the urethra, allowing you to urinate. It may take a few months to be fully functional, and you may still occasionally need a catheter or have incontinence during the night.

    These are major surgical procedures and they do carry risks of complications or side effects, including:

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    How Turbt Is Done

    This surgery is done using an instrument put in through your urethra, so there’s no cutting into the abdomen . You’ll get either general anesthesia or regional anesthesia .

    A type of thin, rigid cystoscope called a resectoscopeis put into your bladder through your urethra. The resectoscope has a wire loop at the end that’s used to remove any abnormal tissues or tumors. The removed tissue is sent to a lab for testing.

    After the tumor is removed, more steps may be taken to try to ensure that the cancer has been completely destroyed. For instance, the tissue in the area where the tumor was may be burned while looking at it with the resectoscope. This is called fulguration. Cancer cells can also be destroyed using a high-energy laser through the resectoscope.

    Large Or Visible Hematuria

    Large or visible hematuria is also called gross hematuria. They may appear pink, red, or brown in the toilet. When visible, the color varies depending on:

    • Amount of blood in the urine
    • Length of time blood has been in the urine
    • Urine level of acidity

    When blood is visible in the urine, you should contact your doctor.2

    “When urinating, I bled like crazy.”

    “Toilet full of blood.”

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    How The Surgery Is Done

    The rigid cystoscope is passed through the urethra into the bladder so the surgeon can see the inside of your bladder on a monitor. The surgeon may remove the tumour through the urethra using a wire loop on the end of the cystoscope. Other methods for destroying the cancer cells include burning the base of the tumour with an electrical current or a high-energy laser.

    If the cancer has spread to the lamina propria or is high grade, you may need a second TURBT 26 weeks after the first procedure to make sure that all cancer cells are removed. If the cancer comes back after initial treatment, your surgeon may do another TURBT or suggest removing the bladder in an operation known as a cystectomy.

    Should I Be Careful With What I Eat Or Drink With A Urostomy

    Growth Of Cancer In The Bladder Stock Illustration

    No, just drink plenty of fluids, like water. Itâs best to limit caffeine and alcohol, because theyâre less likely to keep you hydrated. Thatâs important to lower your chance of infection.

    Go easy on beverages near bedtime, and attach a larger night drainage bag to hold more urine while you sleep.

    Your pouch is odor-proof, so you wonât smell anything until you empty it. If your pee has a very strong odor, it could be a sign of an infection. But other things can affect the smell, too:

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    Can I Shower Bathe And Swim With A Urostomy

    A stoma is a one-way door, so waterâs not a problem. You can shower and bathe with or without your pouch. But itâs best not to use bath oils or soaps with moisturizer.

    Swimming isnât a problem, either. It helps to:

    • Wear a smaller bag or a waterproof cover when you swim.
    • Wear your pouch, but empty it before you get into the water.
    • Use waterproof tape around the edges of the pouch.
    • Wait a few hours after you put on a new pouch before you swim.

    When Should I Call My Doctor

    Let your doctor know if you think you may have an infection. Also tell them if:

    • You have bleeding from the stoma that doesnât stop with a little pressure.
    • You have pain, cramping, or swelling in your belly.
    • Your pouch leaks regularly or doesnât stay in place.
    • Your skin around the stoma keeps getting red or sore.
    • The stoma turns dark purple, brown, or black.

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    Treating Stage I Bladder Cancer

    Stage I bladder cancers have grown into the connective tissue layer of the bladder wall , but have not reached the muscle layer.

    Transurethral resection with fulguration is usually the first treatment for these cancers. But it’s done to help determine the extent of the cancer rather than to try to cure it. If no other treatment is given, many people will later get a new bladder cancer, which often will be more advanced. This is more likely to happen if the first cancer is high-grade .

    Even if the cancer is found to be low grade , a second TURBT is often recommended several weeks later. If the doctor then feels that all of the cancer has been removed, intravesical BCG or intravesical chemo is usually given. If all of the cancer wasn’t removed, options are intravesical BCG or cystectomy .

    If the cancer is high grade, if many tumors are present, or if the tumor is very large when it’s first found, radical cystectomy may be recommended.

    For people who arent healthy enough for a cystectomy, radiation therapy might be an option, but the chances for cure are not as good.

    Palliative Or Supportive Care

    Bladder Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.

    If your cancer is at an advanced stage and cant be cured, your medical team should discuss how the cancer will progress and which treatments are available to ease the symptoms.

    You can be referred to a palliative care team, who can provide support and practical help, including pain relief.

    Page last reviewed: 01 July 2021 Next review due: 01 July 2024

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    What Are The Risks And Benefits Of A Turbt

    As with any type of surgery, there are both risks and benefits to a TURBT procedure. Generally, bladder tumor biopsy and resection is considered a very safe procedure. Some of the possible risks during or after surgery include:

    • Anesthesia-related complications
    • Infections of the urinary tract
    • Bleeding after surgery
    • Perforation of the bladder

    Despite these risks, TURBT procedures are typically a successful treatment for early-stage cancer of the bladder. Having a TURBT can prevent cancer from spreading into the muscle wall of the bladder.

    Transurethral Resection Of Bladder Tumor: References

    Comploj E, Dechet CB, Mian M, Trenti E, Palermo S, Lodde M, Mian C, Ambrosini-Spaltro A, Horninger W, Pycha A. . Perforation during TUR of bladder tumours influences the natural history of superficial bladder cancer. World J Urol. 2013 Oct 29.

    Bishr M, Lattouf JB, Latour M, Saad F. . Tumour stage on re-staging transurethral resection predicts recurrence and progression-free survival of patients with high-risk non-muscle invasive bladder cancer.

    Can Urol Assoc J. 2014 May 8.

    Canter DJ, et al. Initial North American experience with the use of the Olympus Button Electrode for vaporization of bladder tumors. Can J Urol. 2012 Apr 19:6211-6.

    Dalbagni G, et al. Impact of a second transurethral resection on the staging of T1 bladder cancer. Urology. 2002 Nov 60:822-4 discussion 824-5.

    Green DA, et al. Cost-effective treatment of low-risk carcinoma not invading bladder muscle. BJU Int. 2012 Sep 7.

    Han KS, et al. Results of repeated transurethral resection for a second opinion in patients referred for nonmuscle invasive bladder cancer: the referral cancer center experience and review of the literature. J Endourol. 2008 Dec 22.

    Herkommer K, Hofer C, Gschwend JE, Kron M, Treiber U. Gender and body mass index as risk factors for bladder perforation during primary transurethral resection of bladder tumors. J Urol. 2012 May 187:1566-70.

    Herr HW. Transurethral resection of muscle-invasive bladder cancer: 10-year outcome. J Clin Oncol. 2001 Jan 1 19:89-93.

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    Why Is Transurethral Resection Done

    Transurethral Resection is able to reduce the urinary symptoms that is caused by benign prostatic hyperplasia, or BPH. Some of these symptoms are:

    • Difficulty starting to urinate
    • The feeling that you cannot empty your bladder
    • Stopping and starting again while urinating
    • Increased urination at night

    Transurethral Resection is also done to treat or prevent complications that occur with the blocked urine flow. These complications include:

    • Blood in the urine
    • Inability to urinate

    Liquid Biopsies May Aid Diagnosis Treatment Of Bladder Nerve Tumors

    Bladder Cancer Surgery Safe Following Neoadjuvant Immunotherapy ...

    by Julia Evangelou Strait, Washington University School of Medicine

    Blood and urine tests could lead to faster and less invasive methods to diagnose and monitor various types of tumors, new research indicates. Two studies led by Washington University School of Medicine in St. Louis describe the potential of liquid biopsies to identify and track tumor growth in two very different cancers: bladder cancer and peripheral nerve tumors. Despite the differences between these cancers and their associated biopsies, the studies demonstrate the possible benefits of this relatively new tool in the fight against cancer.

    Both studies appear in the Aug. 31 issue of PLOS Medicine, which is a special issue of the journal dedicated to liquid biopsies.

    One study reports the development of a urine biopsy to monitor bladder cancer. With an easy to collect urine sample, doctors could determine whether the initial treatment eradicated the cancer or left some remnants of disease behind. That knowledge could lead to fewer patients undergoing unnecessary surgeries. The second study describes a blood biopsy to diagnose a tumor of the sheathor liningthat covers peripheral nerves. This rare cancer is caused by an inherited genetic disorder called neurofibromatosis type 1 . In patients with NF1, it is difficult to determine whether tumors developing in the nerve sheath are benign or malignant.

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