a. Bladder Cancer b. Resectoscope Cutting Loop cutting tumor
Soon after the initial diagnoses back home at the local hospital I was taken in for an operation to remove parts or the entire tumor in the upper section of my bladder (at that time there was no mentioning or knowledge ((?)) yet of the tumor being invasive into the upper muscle and or lymph node layers in the pelvis area). My family brought me to the hospital that day for me to have the operation. At that time the fact that I had been diagnosed with cancer had put a lot of emotion into my family. It was new and difficult to handle for my family as if I would be instantly dead, or soon… I would have preferred to go alone to the hospital or only with my wife. To see my children in this situation with me, was painful. I had to be in the hospital by 10.00 am and the operation was planned to take place around 13.00hrs. I was given a room and a pill to make me calm. On a bed I was brought to a operation patients collection room. A large room with quite a number of beds all with patients waiting for their individual operation. I was taken away to my operation theater for the operation to begin. We were waiting for the anesthetist to arrive. I looked up from my bed and saw my urologist standing there in his operation dress his arms in gloves crossed over his chest. In front of my bed there was a operation nurse with a horrible (rigid, iron rod like) tool in her hands. She saw my face and the shock on it and turned around quickly with her tool. (See below picture of the resectoscope, the tool that is being used to carry out the TURBT operation by inserting it in the penis, not exactly my idea to have a great time)
The anesthetist arrived and I had to count backwards. I woke up from my apparent state of anesthesia in the same patients collection room where I arrived just before the operation. I woke up in incredible pains and I must have heard trhoughout the hospital when I was screaming for a form of help.
The operation crew rushed back and I could here them things like “the catheter is not 
working”, etc. (See below what a catheter looks like and how they bring them into the penis). The purpose of the catheter is to collect your urine and dispose it in a plastic bag that is either attached to you body or to your bed. With a TURBT operation the urologist may want to continuously “rinse” the bladder removing operation particles, blood etc. that may have remained in the bladder when operating. Sometimes they may also give you an immediate chemo (BCG) after the TURBT that requires continuous washing of the bladder. In my case an immediate chemo was not possible because the outer layers of the bladder may have been damaged during operation and it can be potentially possible for the chemo material to enter other parts of the body. The catheter they did put in me after the operation apparently did not work and urine was blocked to go out into the plastic bag. The amount of liquid collected in my bladder immediately after the operation gave me incredible pains as if my bladder was about to burst. The anesthetist put me back to sleep again and they placed another catheter in me.
Will be continued/completed…
TURBT (Transurethral Resection Of The Bladder Tumor)
Transurethral resection (TUR) for bladder cancer
Transurethral resection (TUR) of the bladder is a surgical procedure that is used both to diagnose bladder cancer and to remove cancerous tissue from the bladder. This procedure is also called a TURBT (transurethral resection for bladder tumor). General anesthesia or spinal anesthesia is usually used. During TUR surgery, a cystoscope is passed into the bladder through the urethra. A tool called a resectoscope is used to remove the cancer for biopsy and to burn away any remaining cancer cells. Bladder cancer can come back after this surgery, so repeat TURs are sometimes needed.
What To Expect After Surgery
Following surgery, a catheter may be placed in the urethra to help stop bleeding and to prevent blockage of the urethra. When the bleeding has stopped, the catheter is removed. You may need to stay in the hospital 1 to 4 days.
You may feel the need to urinate frequently for a while after the surgery, but this should improve over time. You may have blood in your urine for up to 2 to 3 weeks following surgery. You may be instructed to avoid strenuous activity for about 3 weeks following TUR.
Why It Is Done
TUR can be used to diagnose, stage, and treat bladder cancer.
- Diagnosis. TUR is used to examine the inside of the bladder to see whether there are cancer cells are in the bladder.
- Staging. TUR can determine whether cancers are growing into the bladder wall.
- Treatment. One or more small tumors can be removed from inside the bladder during TUR.
How Well It Works
TUR is the most common and effective treatment for early-stage superficial bladder cancer. It may also be effective for more advanced cancer if all the cancer is removed and biopsies show that no cancer cells remain.
Follow-up to TURBT
Transurethral resection is often a successful treatment for patients with low-risk cancers. These cancers are described as noninvasive, papillary cancers. The noninvasive characteristic keeps them from penetrating into deeper layers of tissue but does not prevent their recurrence. Up to seventy percent of patients with superficial bladder cancer have some recurrence within five years of treatment. Therefore, follow-up therapy is an important part of post transurethral resection therapy.
Follow-up therapy includes a cystoscopic evaluation three months after the initial TURBT treatment and then every six months for an additional year. If cancer reappears, follow-up cystoscopy and urinalysis is typically performed every three months for the first year and every six months for an additional three to five years.
Partnering Chemotherapy with TURBT
Patients with high-risk tumors – those that are likely to become invasive – may benefit from the TURBT procedure but may need other “adjuvant” treatment. Because of the relatively high chance of progressing (thirty percent), high risk bladder cancers are often treated with transurethral resection combined with intravesical therapy. Intravesical therapy is a type of chemotherapy or immunotherapy instilled directly into the bladder.
Risks
The risks of TUR include : -
- Bleeding.
- Bladder infection (cystitis).
- Perforation of the wall of the bladder.
- Blood in the urine (hematuria).
- Blockage of the urethra by blood clots in the bladder.
