Cystoscopy Transurethral Resection of Bladder Tumour and Chemotherapy

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What is a cystoscopy transurethral resection of bladder tumour (TURBT) and       Intravesical Chemotherapy?

 A cystoscopy and TURBT is a procedure where tumour is removed from the bladder through the urethra. A small telescopic instrument called a resectoscope is passed through the urethra into the bladder. A resectoscope is used to cut the tumour from the inner layer of the bladder wall, sealing off any bleeding areas at the same time. Any tissue that is removed is then sent for laboratory testing.

Many cystoscopy and TURBT’s are a day procedure which means that an overnight stay is not required, often a catheter is required and an overnight stay is then necessary.

Intravesical chemotherapy is used only for non-invasive or minimally invasive bladder       cancers.

Preparing for your procedure:

We will provide you with instructions regarding all aspects of preparing for your operation.

  • Pre-operative blood and urine tests.
  • Details of admission to hospital.
  • Information regarding fasting and medications.

What to expect afterwards:

You are usually able to eat and drink what you feel like after the surgery. You will be encouraged to maintain a good fluid intake. Pain relief is always available, however, it is not usual to have significant pain after this procedure. You will most likely experience irritation and have a frequent need to urinate afterwards. There will most likely be some blood in the urine which should settle within a few days.

If you have a catheter, it will be attached to a bag and drain urine from the bladder. You may have fluid bags attached and fluid irrigating slowly through to help prevent blood clots forming in the bladder. In the recovery area, chemotherapy will be placed in the bladder. The catheter will usually be removed the following day. A combination of the surgery and the catheter can cause bladder irritation and sometimes bladder spasm.

After removal of the catheter there will most likely still be some blood in the urine. Once we can see that you are passing urine satisfactorily, you are then able to go home.

You will be given pain relief if required and antibiotics if necessary to take home with you.

Complications:

This is generally a very safe procedure with a low risk of complications.

  • The chance of infection is <5%.
  • Significant bleeding requiring readmission to hospital or blood transfusion is <5%.
  • The chance of an injury or perforation of the bladder is <1%.

After discharge from hospital:

You should drink extra fluid over the first week or two after surgery. Drinking 1500-2000mL per day is usually satisfactory. Do not drink excessively. Aim to keep your urine a pale yellow or straw colour. If you find your urinary symptoms are not improving or become worse, then you could have an infection. Either contact our office or see your GP to organise a urine test.

If you do notice blood in the urine, then drink extra water to dilute the urine. Occasionally there is more excessive bleeding, and large clots in the urine that make it difficult to pass. If this occurs, please contact our office, contact your GP or present to a hospital emergency   department for assessment.

You should be able to recommence most of your usual activities shortly after surgery. Please avoid heavy lifting or straining until bleeding settles. Sexual activity can be recommenced once the bleeding settles. One in five have secondary bleed at 2 weeks and it is important to be careful around this time.

Driving:

You should not drive for at least 3-4 days after having the operation (or as instructed by your Urologist).

Patients who are travelling outside the metropolitan area are required to check when they are able to travel, and will be required to stay in the metropolitan area for 24 hours (or as instructed by your Urologist).

Emergency Contacts:

In the event of an emergency, call our office within business hours and speak to our Practice Nurse.  If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.

Ashford Hospital (8375 5205)

55 Anzac Highway, Ashford SA 5035

Emergency Department is open 7 days a week, 8:00am until 10:00pm

Wakefield Hospital (8405 3440)

300 Wakefield Street, Adelaide SA 5000

Emergency Department is open 7 days a week, 24 hours

**For patient’s outside the Metropolitan area, please present to your nearest hospital emergency department.

Follow up:

A post operative appointment will usually be made for you prior to your procedure. Please ask your urologist, or contact our rooms to ensure arrangements are in place. If you have travelled from the country for your procedure then a phone call may be arranged for review or by telehealth.

If you have any concerns after your procedure, please contact our office and speak to one of the practice nurses.