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Transurethral Resection of Bladder Tumor

Definition
The bladder is part of the urinary tract, sitting in the lower part of the abdomen. Its purpose is to hold urine. Urine is made in the kidneys and contains water and waste materials. A tube called the ureter comes from each kidney and drains the urine down to the bladder. There are two types of cells that line the inside of the bladder. 
There is a thin layer of cells beneath this lining called the lamina propria. The outer layer of the bladder wall contains a thick layer of muscle tissue which contracts from time to time to push out the urine. Urine is passed via the urethra, or waterpipe. Sometimes, cancers, or tumours, can develop in the cells that line the bladder. Patients may have already undergone a Cystoscopy, or examination of the lining of the bladder, to confirm the presence of any tumour or cancer. Trans urethral Resection of Bladder Tumour is an operation performed on patients who have cancer or a tumour in the bladder. The procedure allows the surgeon to remove as much of the tumour as possible.The resulting tissue sample is sent to the laboratory for analysis.There is no need to cut and therefore there are no external scars.Trans Urethral Resection of Bladder Tumour is performed by use of a telescope passed up the urethra. The tumour is then either partially or totally cut away.Recovery can take anywhere from two to eight weeks. During the first few weeks after the operation,
Benefits
The expected outcome of this operation should be:
• Removal of the tumour in the bladder and prevent spread of any cancer to the other organs in the body
• To obtain a tissue sample so that any further treatment can be planned. 

About the operation
A thin rod-like instrument with a tiny light and lens on the tip, called a cystoscope, will be carefully inserted into the urethra (the tube that carries urine out of the body). Saline solution (salt water) will be passed through the cystoscope to fill the bladder up and to make the whole of the lining visible.

Your surgeon will find the lesion and insert a special wire loop through the cystoscope. An electric current is passed down the wire loop and used to cut or burn off the lesion. This also seals the wound to stop any bleeding. Some healthy tissue around the lesion may also be removed.

At the end of the procedure, the cystoscope is taken out and a catheter (a thin flexible tube) is passed in to the urethra and left in place for about 24 hours. The catheter will drain urine from your bladder into a bag. The catheter may also be connected to a system which washes any blood and blood clots out of your bladder. This is called bladder irrigation.The removed lesions are sent to a laboratory for examination. If the bladder lesion is cancerous, the tests will show how far the cancer has spread and if further treatment is required. In some cases, removing the lesion is all that is needed. The procedure usually lasts 30 minutes (slightly longer if more than one lesion is present).

After the Operation

When you return to the ward after the operation you will have an intravenous drip inserted into your arm in order to provide your body with fluids. You will also have a catheter inserted into your bladder which is a flexible hollow tube used to drain the urine. This catheter is held in place by an internal balloon which prevents it from falling out.Your urine may be quite bloody after the operation. This is quite normal. In order to wash the bladder out after surgery and prevent any blood clots from blocking the exit of the bladder, the catheter will have irrigation fluid going into it. This will stay in place until the urine is fairly clear. The catheter is usually removed a day or two after surgery once the bleeding has settled.

Sometimes it is necessary to instil medicine into the bladder following this type of surgery. In this instance the catheter will remain in place until this has happened, usually the next day.