INTRODUCTION:

TURBT is the procedure done to diagnose and to treat early stage bladder cancer at the
same time. The initials stand for transurethral resection of a bladder tumor. This
procedure is the first-line diagnostic test and treatment for bladder cancer. Men are
almost four times more likely than women to be diagnosed with this type of cancer.

The majority of people have bladder cancer that hasn’t invaded the muscle wall when
first diagnosed. Almost everyone diagnosed with bladder cancer will undergo bladder
tumor biopsy and resection.

A biopsy is a procedure in which a doctor takes a tissue sample from the area where
cancer may exist. During the biopsy procedure, the doctor also will try to remove the
cancerous growth. This is called resectioning. The entire procedure for bladder tumor
biopsy and resection is known as transurethral resection of bladder tumor (TURBT).

INDICATION FOR OPERATION:

This surgical procedure is used in both the diagnosis and treatment of bladder cancer.

Transurethral resection of bladder tumor (TURBT) allows your surgeon to biopsy your

tumor, or remove an entire small tumor from the inside of your bladder, while leaving the

bladder intact. TURBT is essential to obtain a biopsy to confirm the cancer diagnosis

and determine the stage and grade of your cancer.

PREPARATION FOR OPERATION

Normally, you have to stop eating and drinking the night before any procedure that

requires anesthesia. Make sure your provider knows about all of the medications that

you take, including over-the-counter medicines and supplements.

Your healthcare provider will tell you if you need to avoid taking any of your medication

— for instance, blood thinners — and when you should stop. Don’t just stop taking

medication without discussing it with your provider.

If you’re allowed to take medications in the morning before the TURBT, make sure you

only take a sip or two of water.

Take a bath or shower before you go in for the procedure. Don’t use any kind of lotions

or perfumes or deodorants after your shower.

Dress comfortably the day of the procedure. Bring identification, but leave your money,

credit cards and jewelry at home.

Bring someone who can drive you home. Between anesthesia and pain medication, it

won’t be safe for you to drive yourself.

PROCEDURE FOR OPERATION

The tumors can be removed through a probe passed up through a cystoscope. The
tumors are then removed through the cystoscope and sent for microscopic exam. The
results should be available in 5 to 7 working days. Your doctor will be discussing the
results with you.

TURBT is the procedure done to diagnose and to treat early stage bladder cancer at
the same time. The initials stand for transurethral resection of a bladder tumor. This
procedure is the first-line diagnostic test and treatment for bladder cancer. Men are
almost four times more likely than women to be diagnosed with this type of cancer.

The majority of people have bladder cancer that hasn’t invaded the muscle wall when

first diagnosed. Almost everyone diagnosed with bladder cancer will undergo bladder

tumor biopsy and resection.

A biopsy is a procedure in which a doctor takes a tissue sample from the area where

cancer may exist. During the biopsy procedure, the doctor also will try to remove the
cancerous growth. This is called resectioning. The entire procedure for bladder tumor

biopsy and resection is known as transurethral resection of bladder tumor (TURBT).

You may have general anesthesia for this procedure, which means you’ll be asleep for
it. Some providers might use regional (or spinal) anesthesia, which means you’ll be
awake. However, you won’t feel any pain.

Bladder tumor biopsy and resection is performed when a doctor inserts a rigid
instrument called a resectoscope into the bladder through the urethra. (This is the
meaning of the word transurethral.) Inserting the resectoscope in this way means that
no incisions are necessary.

Your provider will use the resectoscope to remove the tumor, which will be sent to a
pathology lab for testing. Once the tumor is removed, your doctor will attempt to destroy
any remaining cancer cells by burning the area using electric current by a process
called fulguration or cauterization.

Your provider may decide to insert some type of chemotherapy medicine into the
bladder using the scope. This is called intravesical chemotherapy. Your provider might
suggest that you have maintenance intravesical chemotherapy for a period of time,
meaning that you'll have regular treatments.

POSTOPERATIVE MANAGEMENT

What to expect after surgery

Your urine may be bloody, but it should clear 2 – 4 days after you are home. Blood in
your urine may last up to 4 – 6 weeks. You may have some irritation and burning with
urination.

What to do

● Drink plenty of fluids, 10 – 12 (8-oz.) glasses per day.

● Take your pain medicine as prescribed, when needed.
● Get plenty of rest.
● Avoid letting your bladder get too full as this would increase the pressure in your
bladder and make you bleed more.
 ● Avoid straining and constipation; increased pressure can cause more bleeding.
You can prevent constipation by drinking fluids and adding fruit and vegetables to
your diet. Stool softeners or a mild laxative may be prescribed by your doctor.

Activity restrictions

You can resume your normal activities in 3-4 weeks.

During the first week at home

● Do not lift anything weighing more than 5 to 10 lbs.

● No strenuous activities (i.e. aerobics, jogging, swimming).
● Limit stair climbing to 1-2 times per day.
● No sexual activity.
● Do not drive until OK with your doctor.

During the second week at home

● You may slowly increase your activity, but rest when you get tired.
● Do not overexert yourself.
● You may resume sexual activity after the second week.
● You may drive if you are not taking prescription pain medicine and if it is OK with
your doctor.

You may return to work during the third week or when your doctor allows.

INSTRUMENT USE USE FOR THE PROCEDURE

NCP FOR THE CASE:

ASSESSMENT:
OBJECTIVE:
● Inaccurate follow through of instruction
INFERENCE:
Transurethral resection of bladder tumor (TURBT) is a medical procedure that is
used to remove tumors from the surface of the bladder wall. The bladder is accessed
through the urethra, the tube that carries urine out of the body from the bladder.
TURBT is an alternative to open surgery, during which a large incision is made in the
belly in order to reach the bladder.

NURSING DIAGNOSIS: Deficient knowledge related to lack of information on allergens that

triggers the turbt.

OUTCOME IDENTIFICATION: TURBT is most successful for patients with small,

single tumors that have not spread to other tissues. Success rates in these cases is
around 60 to 70 percent.

PLANNING:
After 30 minutes of nursing intervention the patient will be able to participate in learning process

NURSING INTERVENTION/ RATIONALE:

● Ascertain level of knowledge, including anticipatory

needs.
● Provide positive reinforcement
● Determine clients most urgent need from both
clients and nurse viewpoint
● State objectives clearly in learner’s terms
● Determine client’s method of accessing information
● Provide mutual goal setting and learning contacts
● Provide access information for contact person
● Provide access information about additional
learning resources

RATIONALE:

● To assess readiness to learn

● Can encourage continuation of efforts
● Which may differ and require adjustment in teaching
plan
● To meet learner’s need
 ● To facilitate learning or recall
● Clarifies expectations of teacher and learner
● To answer questions and validate information post
discharge.
● May assist with further learning and promote
learning at own pace.

EVALUATION:
Goal met
After 30 minutes of nursing intervention the patient was able to participate in learning process