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Surgery for Bladder Cancer

Treatment of non-muscle invasive bladder cancer:  Surgery

Surgery is the main treatment for non-muscle invasive and early bladder cancer. It may be the only treatment that is needed or it may be combined with drug treatment given into the bladder.

The cancer or cancers can usually be removed surgically, using a cystoscope.  This procedure is called a Transurethral Resection of Bladder Tumour (TURBT).

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Before surgery

Before surgery you’ll have a blood test to check your general health. You can also discuss the surgery with a specialist nurse or a doctor. You’ll then have a medical examination to make sure that you’re fit enough to have an anaesthetic.

You’ll be admitted to the surgical ward on the day of surgery. The surgeon or anaesthetist will talk to you about your operation and ask you to sign a consent form.

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The operation

You’ll be given a general anaesthetic and a cystoscope will be inserted into your bladder. The tumour is cut out or burnt off (cauterised) using a mild electrical current.

The whole procedure is done in this way and several tumours can be treated at the same time if necessary. You won’t be left with a scar because there’s no wound.

The operation usually takes 20-60 minutes. You may be given chemotherapy into your bladder the morning after surgery.

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After the operation

When you go back to the ward you’ll have a thin, flexible tube (a catheter) in your bladder, which drains your urine into a bag. It may make you feel as though you want to pass urine.

Your urine will be bloodstained at first but this should disappear after a few days.  Once you are drinking normally and your urine looks clear, the catheter will be taken out. This is not painful but may feel a little uncomfortable. Once the catheter has been removed and you are passing urine satisfactorily you’ll be allowed to go home. This is usually on the day after the operation.

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Possible risks of surgery

Removing early bladder cancers is a safe procedure. However, it can have some risks:

  • Urine infection
  • Bleeding for more than a few days.  This occasionally requires a further operation or blood transfusion
  • Damage to the bladder.  There is a very small risk of a hole (perforation) being made in the bladder during surgery. If this happens it can usually be managed by leaving a catheter in the bladder for about 7-10 days, to drain the urine and allow the hole to heal. Very rarely a second operation is needed to repair the hole.

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Need for further surgery

If there’s a risk that some cancer cells may have been left behind, your doctors may decide that a second operation is needed. This can happen when the tumour removed is high grade (more aggressive) or shows early signs of invasion of the bladder wall.  This second procedure normally takes place 6 weeks after the first operation.

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After surgery

After your operation your doctors will know more about the type of cancer you have. This information helps them decide the most appropriate treatment for you. You may be advised to have further treatment with chemotherapy or BCG to reduce the chances of the cancer coming back (recurring) or growing into the muscle (becoming invasive).

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