Transurethral resection (TUR) of the bladder are used for diagnostic and therapeutic purposes of:
- Examine the internal body cavity for the presence of malignant cells.
- Determine whether the cancer has sprouted into the body wall.
- Remove one or more small tumors.
The bladder is a hollow, muscular organ located in the pelvic area. Its function - the collection, storage and excretion of urine from the body.
TURBT - the most common and effective means to treat cancer in the early stages of the disease (non-invasive papillary carcinoma, and carcinoma in situ).
Repeated transurethral resection performed for superficial bladder tumors. In the process of TUR often administered cytostatics or biological agents (BCG). Also, for the destruction of the tumor can be used laser destruction.
TURBT employ at II - III stage disease when treatment is planned with cytotoxic drugs and radiation.
What is the operation TOUR bladder?
During this procedure the removed pathological tissue by means of a special tool. It is equipped with light telescope (optical system providing full visualization) and a special electrode, which safely shuts off the damaged tissue and carries accurate coagulation. Assuta Hospital uses the latest bipolar instruments that have greater functionality. When they are used virtually eliminates the possibility of thermal burns of healthy tissue and potential complications.
Bladder tumors can be benign, but most of them are malignant character. Benign tend to grow very slowly. But if left untreated, increases the size of tumors and can be a problem, putting pressure on other organs. Cancerous tumors are removed when it is not, continue to grow. They are able to invade surrounding tissue and spread to other parts of the body, causing various disturbances.
There are several different types of bladder cancer, the most common is transitional cell carcinoma. Less common are squamous cell carcinoma, sarcoma and adenokartsionma.
Factors that may increase the likelihood of this disease include smoking, exposure to chemicals, infections and some tropical parasites.
When choosing methods of treating the disease, doctors will focus on the type of malignancy and spread in the body.
Preparation for surgery TURBT
The preparatory period includes a series of tests in the clinic Assuta:
- Blood tests check the overall health before surgery. The sample is sent to the blood bank for determining compatibility with the donor, which is prepared for transfusion if necessary during or after surgery. Pre-patient signed a written consent.
- Urinalysis verifies the presence of bacteria.
- Chest X-Ray explores the state of lung health.
- ECG heart may be imposed in connection with age or any heart disease.
Since the stomach must be empty before anesthesia, the patient does not have to eat and drink milk drinks for 6 hours before the operation.
Also, stop taking medication, blood thinners - aspirin, warfarin or clopidogrel.
During surgery it is using general anesthesia or spinal anesthesia.
Potential complications of transurethral resection of the bladder
This procedure carries a small risk of the following side effects.
- Heavy bleeding. Doctors monitor the vital signs (blood pressure and pulse), urine for signs of bleeding.
- Urinary tract infections. Provides temperature monitoring for early signs of infection, timely intervention is performed if necessary. To reduce the risk, antibiotics are injected directly into the bloodstream during surgery, if required, also in the postoperative period. The goal of preventing the patient is able to contribute - to maintain an adequate level of hygiene, to perform deep breathing exercises. As are the benefits of early mobilization.
- Blood in the urine - a common phenomenon, there may be a slight burning sensation during urination. It is recommended to drink plenty of fluids. Applicable body irrigation.
- Bladder perforation. Sometimes you need to remove the tumor, which is deeply ingrained in the body, which will cause the formation of a hole in his wall. In order to ensure the restoration of bladder catheter is installed on a few extra days.
The period of hospitalization
The usual length of stay in the clinic Assuta - from one to two days.
What happens during surgery TOUR bladder?
To improve visibility into the bladder poured sterile saline. Through the urethra to the affected organ surgeon inserts resectoscope. On the monitor, the doctor sees the inner surface of the body.
Wire elektropetlya resectoscope allows to cut the tumor mass and the segment of healthy tissue, to produce sealing wound. Small papillary tumors are removed entirely, neoplasms of medium and large size - segmental. Then Resected tissue is sent for further investigation. The operation lasts from fifteen minutes to one hour.
After TUR bladder Assuta
After transurethral resection of the patient is transferred to the recovery room, where his condition is monitored carefully. A nurse regularly monitors:
- Vital signs - blood pressure, pulse, respiratory rate and temperature.
- Extent and location of pain, reducing their effectiveness.
- Colored urine.
- The amount of oxygen in the blood.
It may be installed in a drip forearm vein for the delivery of drugs and fluids in the body. Also connects the urinary catheter to drain urine. It is removed after one - two days after the operation. Then sometimes there are temporary problems with bladder control.
Often in the first 24 hours gives oxygen via nasal cannula or mask, which makes it easier breathing and promotes the healing process.
Pain after TUR of the bladder
Although not visible wounds will be defined within an organ damage. The area where the tissue was removed, it may cause some discomfort, burning, when will be the filling and emptying of the bladder. Doctors, interacting with the anesthesiologist, prescribe medication, to facilitate this condition and reduce the level of pain to a minimum. Its expression is evaluated from 0 to 10. The following methods are used either individually or in combination:
- Receipt of intravenous analgesics.
- Oral administration of drugs.
- Means for alkalinization of urine. When burning sensation during urination these drugs, reducing the acidity of the urine can be assigned.
Continuous irrigation of the bladder
After TUR of the bladder urine will contain a certain amount of blood, which can cause a blood clot and cause blockage. Therefore, for 6-24 hours catheter connected to an irrigation system, the body carrying out washing to prevent such problems.
Eating and drinking
In a short period of time the patient can go to a normal diet as soon as completely get rid of the effects of anesthetics. If you experience nausea and vomiting, prescribers to facilitate state. In moderation it is recommended to consume spicy foods, caffeinated beverages. It is important to drink plenty of fluids.
Movement of the patient will be limited as long as irrigation is carried out of the bladder. After the catheter is removed the patient can get up. Mobility will facilitate the healing process.
When can I return to normal activities?
To work could begin in the middle after 2 weeks. In general, this will depend on the recovery process and the type of work. If the work is, for example, involves heavy lifting, it can take three - four weeks. Recommended sparing exercises a week after TUR of the bladder .
The results of transurethral resection
10-14 days after surgery will be available the results of which will determine further action. If a patient with bladder cancer, but there is no need for further invasive treatment require regular cystoscopy, which detects the presence or absence of recurrence - once every three months, then less frequently. If you want to follow therapy or cancer from coming back, your doctor will discuss with the patient's future appointments.
What are the alternatives TOUR bladder?
If malignant tumors recur, it may be offered chemotherapy or immunotherapy. Transurethral resection is the first procedure that involve the treatment of this disease.