Transurethral bladder resection is a surgical procedure for the treatment of bladder cancers. This is performed with spinal or general anesthesia.
In this procedure, a resectoscope which is a lighted tube is inserted through the urethra, into the bladder. A clear solution is infused to maintain visibility and the tumor or tissue to be examined is cut away using an Electrocautery. A sample of the tissue is cut out and examined, usually under a microscope in order to evaluate the depth of tissue involvement, while avoiding perforation of the bladder wall. Every attempt is made to remove all visible tumor tissue, along with a small border of healthy tissue. The resected tissue is examined under the microscope for diagnostic purposes. An indwelling catheter may be inserted to ensure adequate drainage of the bladder postoperatively. At this time, interstitial radiation therapy may be initiated if necessary.
Transurethral resection is the initial form of treatment for bladder cancers. The procedure is performed to remove and examine bladder tissue and/or a tumor. It may also serve to remove lesions and it may be the only treatment necessary for noninvasive tumors. This procedure plays both a diagnostic and therapeutic role in the treatment of bladder cancers.
Diagnosis/Preparation
If there is reason to suspect a patient may have bladder cancer, the physician will use one or more methods to determine if the disease is actually present. The Transurethral bladder resectiondoctor first takes a complete medical history to check for risk factors and symptoms and does a physical examination. An examination of the rectum and vagina (in women) may also be performed to determine the size of a bladder tumor and to see if and how far, it has spread. If bladder cancer is suspected, the following tests may be performed:
In most occasions, the cancer begins as a superficial tumor in the bladder. Blood in the urine is the usual warning sign. Based on how they look under the microscope, bladder cancers are graded using Roman numerals 0 through IV. In general, the lower the number, the less the cancer has spread. A higher number indicates greater severity of cancer.
Because it is not unusual for people with one bladder tumor to develop additional cancers in other areas of the bladder or elsewhere in the urinary system, the doctor may biopsy several different areas of the bladder lining. If the cancer is suspected to have spread to other organs in the body, further tests will be performed.
Because different types of bladder cancer respond differently to treatment, the treatment for one patient could be different from that of another person with bladder cancer. Doctors determine how deeply the cancer has spread into the layers of the bladder in order to decide on the best treatment.
Standard with any surgical procedure, the patient is asked to sign a consent form after a thorough explanation of the planned procedure.
Like others this surgery also has some risks associated to heart and lung problems or the anesthesia itself, but these are generally extremely small. Other complications include Bleeding and infection. Bladder irrigation may be required to be done if bleeding becomes a complication post-surgery. During this time, the patient will be advised bed rest. Another risk associated with this surgery is Perforation of the bladder. In such cases the urinary catheter will be left in place for four to five days after the surgery. Antibiotic therapy is also started immediately after the surgery as a preventive measure. If the bladder is lacerated accompanied by spillage of urine into the abdomen, an abdominal incision may be required.
As with any surgical procedure, blood pressure and pulse will be monitored. Urine is expected to be blood-tinged in the early postoperative period. Continuous bladder rinsing may be used for approximately 24 hours post surgery. Most operative sites should be completely healed in three months. The patient is followed closely for possible recurrence with visual examination, using a special viewing device (cystoscope) at regular intervals. Because bladder cancer has a high rate of recurrence, frequent screenings are recommended. Normally, screenings would be needed every three to six months for the first three years and every year after that, or as the physician considers necessary. Cystoscopy can catch a recurrence before it progresses to invasive cancer, which is difficult to treat.
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Few Major Hospitals for Transurethral Resection of Bladder Tumor are:
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