Bladder cancer is a common cancer affecting both men and women. The most common histologic type is Transitional Cell Carcinoma (TCC), which is a cancer of the urothelium of the urinary tract; stretching from the kidney linings, down the ureters, and lining the bladder. In fact, being diagnosed with TCC of the bladder holds an associated up to 10% risk of developing kidney/ureter TCC at some point as well.
Bladder cancer most typically presents with no symptoms, but with microscopic blood in the urine on testing. Some patients may develop urgency and urinary frequency, others might have some pelvic or bladder discomfort. Rarely would one develop blood in the urine that you can see with your naked eye.
Diagnostic testing would include imaging such as ultrasound or CT scans, as well as cystoscopy; putting a telescope through the urethral opening, examining the urethral lining, and into the bladder. Once the diagnosis of bladder cancer is established, it becomes necessary to resect the lesion in order to confirm the histologic type, its aggressiveness, and tumor penetration depth into the bladder wall. This procedure is called a Transurethral Resection of Bladder Tumor (TURBT).
The TURBT procedure is much like cystoscopy or other endoscopy, but performed as an outpatient day procedure in the Hospital. You will be brought to the OR suite, given general anesthesia and placed in the dorsal lithotomy position (legs in stirrups). A special Resectoscope will be introduced per urethra and used to examine the urethra up to and including the bladder. An electrified loop of wire through the Resectoscope will be used to cut the offending lesion from the bladder wall, and a separate resection of the base of the lesion may be taken in order to stage the tumor depth via sampling. The base and surrounding area are cauterized to prevent bleeding, and then the instruments removed. You will be recovered in PACU and discharged when well. Pathology reports take about a week to come back after analysis.
Depending on the results of Pathology, you may just be put on surveillance cystoscopy to monitor for tumor recurrence, or you may have to have additional therapy including partial or total removal of the bladder (cystectomy) and/or chemotherapy or radiation.
