TURBT Surgery Questions

[Joey M]

I am awaiting a surgery date, hopefully I’ll hear soon.  My questions are related to the surgery itself, and recovery from surgery.

I have found information on the surgery itself.  I am wondering if a spinal rather than a general anesthetic is sometimes used.  It would be my preference, but it doesn’t seem common.

I have not found information on the recovery.  As the surgery is non-invasive and day surgery, I am thinking/hoping that recovery is simple.  I’m trying to find out if this impression is accurate.  Does it put you down at all post surgery?

Thank you.

 

 

[raincity]

Hi Joey, I only had one TURBT before bladder removal, my cancer was into muscle at the TURBT. I had full anesthesia by a mask device, when I woke up about 4 hours later in a recovery room, I found I had a Foley catheter on and I had to wear it for 5 (7?) days. A stent was inserted in my ureter to relieve the blockage from the tumour. I went home the same day but was very dizzy, urine was red with tissues for days. But I felt much better because the blockage from tumour was gone. Pathology report took three weeks, maybe because it was a rare type of cancer so the results took longer? Wish you good luck, it’s depends on how deep and how much your surgeon needs to take out.

[marysue]

Hi Joey:

I have had 3 TURBTs to date all with general anesthesia.  Spinal anesthesia can be an option for some but it does come with its own set of risks.  I suggest contacting your surgeon to ask if that would be an option for you if that is your preference.  When I was waiting in the hallway on the stretcher to go to the OR, the anesthesiologist came to see me and asked about when I last ate, drank.  He looked in my mouth to see what it was like and about what fake teeth I had – 3 for me.  He did offer me a choice of a spinal or general.  I opted for the general because I’m a complete wuss in the OR.  I don’t want to know a thing.  It could be that like me,  it will be the anesthesiologist that will advise you on whether you have the choice or not.

Once your surgery is booked you will most likely have a preop physical and a EEG/EKG.  My physical, EEG and preop lab work were all done at the hospital the week before my surgery.

My first two TURBTs were uneventful.  I stayed overnight and the catheter was removed the next morning.  I went home after the nurses were satisfied that I could pee well enough.  I was given scripts for a painkiller and antibiotic.  I didn’t need the painkiller as Tylenol was sufficient but did take the antibiotic as a precaution against post op infection.

My 3rd TURBT was a totally different story.  Because this time due to it being a different and potentially more serious type of cancer, I had a chemo agent called Epirubicin instilled in my bladder post op.  It caused massive inflammation which caused post opt urinary issues and a strep infection.  I also went home with a catheter for 5 days.  I was glad of it so I could sleep through the night.

I have to correct you on the term invasive.  It is invasive but not as much as an open abdominal surgery.  As you may have read a scope is put up the urethra similar to when you have a cystoscopy exam and a surgical tool that can cut out the tumour and cauterize the surgical wound can be inserted via this scope.  You can expect to have a post op catheter in for several hours, overnight or even go home with the catheter for a few days depending on your situation.

For recovery I have the following tips:

1) Drink lots and lots of water.  Yes, you will pee way more to the point that it is annoying but it will keep your urine diluted and lessen the chance of a post op infection and speed healing. It will also flush all the drugs from the surgery out of your system faster. Stay away from caffeine for several weeks as caffeine irritates the bladder wall and could interfere with healing.

2) Rest a lot for the first 2-3 weeks after surgery.  Alternate rest with short walks as able around the house, outside your property and maybe after a bit up and down the street.  And I emphasize short, not a 5-10 mile hike up in the mountains. With the first couple of weeks you may find that you are more tired than usual.  Some days will be better than others. Give yourself permission to nap.  Your body will thank you for it. If you are into exercise routines like yoga wait about a month before resuming.  Too much bending and assuming complex positions will loosen the scabs on the wounds and you will bleed more.  I speak from experience here.

3) DO NOT do any heavy lifting, snow shoveling, active sports, heavy housework or heavy physical work duties for 4 -6 weeks post op.  This is important to allow the surgical area to heal over.  It takes time to heal because of the wet environment of the bladder and the fact that the wound is only cauterized not stitched.  If you are working and normally do heavy physical tasks ask your surgeon about when it would be safe to assume regular duties.  You may need to talk to your employer about switching to lighter duties for a few weeks.

4)  You can expect to see some blood/small clots in your urine post op for 2-6 weeks.  It may stop and start/come and go.  If the bleeding increases suddenly and/or you have lots of large clots and pain drink lots of water, rest and contact your doctor.  If needed head to the ER preferably at the hospital where you had the surgery.  The same goes for if you are experiencing difficulty urinating post op.  If you can’t go or have real difficulty emptying your bladder this is a medical emergency.  Head to the ER. I had this experience post op with my last TURBT.  Trust me, this is the one time that you will actually beg for a catheter!

5) Watch for any signs of UTI (Urinary Tract Infection) – cloudy/foul smelling urine, burning, urgency, fever, chills, abdominal pain.  If you experience any of these symptoms contact your doctor ASAP.  You would need an antibiotic to clear it up.

6) Take any necessary pain killers post op.  Sometimes we like to be brave and try to tough it out but this will interfere with your ability to get sufficient rest which in turn will affect your ability to heal.  Also you may or may not be prescribed a post op antibiotic.  Urologists really vary on this so if you are concerned this would be a question to ask about what is right for you.

7)  Ask your surgeon about when  you are able to drive post op and if you are in a relationship resume intimacy.  Most people can drive about a week after surgery and need to wait about 4 weeks for sex.

Personally, I found the first two times I needed about a month to fully recover.  The first time I was a stay at home mom so I could schedule my life as able.  The second time I was working part time retail.  Based on my previous experience, I took three weeks off and my first two weeks back were on 1/2 time.  After that I was able to ramp back up to my 20-25 hours a week.  This time around, I’m retired and it was a good thing because of all the issues that I had post op. I took about 7-8 weeks to recover this time.

So, I think the long and short of what I’m saying is:  Be prepared to slow down anywhere from 1-6 weeks.  If you are working speak to your boss about arranging the time off.  You will need at least a week, no matter how good you are feeling.  I suggest considering taking more time off if you have a heavy physical job. Even if you are not working, clear your calendar of everything except the absolute essential.  Enlist some help for things like laundry, essential household cleaning,  grocery shopping etc. Some people recover quickly without issue.  Some take longer and other underlying health conditions can play a big part in that.  The more you rest in the beginning along with drinking copious amounts of water will aid you in speedier healing.  The amount of surgery is another factor – the removal of one tumour is less trauma to the bladder than several tumours.  Many people make the mistake of rushing back into full swing far too soon.  You may feel just fine afterwards but remember that your bladder has just gone a boxing round in the OR and needs you to take care of it.  If you take it easy, your bladder and body will thank you for it.

I hope this helps.  If you have any further questions please post and we’ll do our best to answer – no question is a dumb question.  This is a whole new learning curve.  Take care and best wishes.  ((((HUGS))))

[Joey M]

Thank you for sharing.

[Joey M]

Thank you for sharing.  Your third TURBT sounds very stressful.  Hope you are well into recovery now.

[Edwin Castle]

Hi Joey

Just a quick note. I did have a spinal done for my second Turbt. This was at the beginning of  covid and they wanted to save the ventilators for possible covid patients.  Anyway I found the experience quite different. I was in what they call a twilight state, you can hear and feel pressure but it is like a dream.

I found the overall recovery time easier to handle over the next few days, the only thing was my time waiting to get feeling back into my legs, it took much longer than expected, about 5 hours in recovery till I could walk.

Any more questions let me know.

Hope that helps. Have a smooth recovery. Ted.

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