Bladder Tumor: Cystoscopic Resection (TURBT)
The operation you have experienced is a "scraping" operation; that is to say, the bladder tumor or biopsy sample was "scraped" off the bladder wall. Bleeding was controlled with electrocautery which will produce a "scab" in the inside bladder wall. About 1-2 weeks after the operation, pieces of the scab will fall off and come out with the urine. As this occurs, bleeding may be noted which is normal. You should not worry about this. Simply lie down and increase your fluid intake for a few hours. In most cases, the urine will clear. Because of this tendency for bleeding, aspirin (or Advil) must be avoided for 2 weeks following your operation (Tylenol is okay). If bleeding occurs or persists for more than 12 hours or if clots appear impairing your stream, call your surgeon.
You may be instructed to wear a catheter when going home. Your surgeon will tell you how long to keep it in and when to take it out. The nurses will explain to you how to keep it clean and how to use the drainage bag. You will also be taught how to remove the catheter, which is quite easy and produces little discomfort. Some patients find that placing antibiotic ointment around the catheter at the tip of the penis will reduce irritation. Most people find that catheter drainage into the "overnight bag" is most convenient because it simply holds more urine and does not require frequent emptying as does the leg bag. Also, it may be more convenient to wear loose fitting pants, like sweat pants or exercise pants with side snaps. The leg bag may be clipped to the pants and conveniently carried. When wearing the leg bag be careful that it does not overfill. In addition, a leg bag should be worn only during walking times because when sitting the urine may back up into the catheter. It is normal to pass small clots through the catheter although in general the urine should be clear. It may become blood tinged periodically. Please call you doctor if the catheter stops draining or if you see multiple large clots or persistent blood.
You will be given a prescription for antibiotics to be taken for about one week. This is to help prevent infection. If you develop a fever over 101°, or have chills, call your surgeon. Although not common, this may indicate infection that has developed beyond the control of the antibiotics that you have taken.
It will take 6 weeks from the date of surgery to fully recover from your operation. This can be divided into two parts -- the first 2 weeks and the last 4 weeks. During the first 2 weeks from the date of your surgery, it is important to be "a person of leisure". You should avoid lifting and straining, which also means that you should avoid constipation. This can be done by any of 3 ways: 1) modify your diet, 2) use stool softeners which have been prescribed for you, and 3) use gentle laxatives such as Milk of Magnesia which can be purchased at your local drug store. It is important for you to avoid prolonged sitting. You should avoid sexual activity during this time. Also, avoid driving. The danger is not so much the driving, but it may delay you from urinating if you have the urge; and, "holding" urine may cause bleeding. If you return to work before 2 weeks, you may feel fatigued and require a decreased work load.
During the second 4 week period of your recovery, you may begin regular activity, but only on a graduated basis. For example, you may feel well enough to return to work, but you may find it easier to begin on a half-day basis. It is common to become quite tired in the afternoon, and if such occurs, it is best to take a nap! Also, you may begin to drive as well as lift objects such as a briefcase, etc. If you are a golfer, you may begin to swing a golf club at this time. Sexual activity may be resumed during this time, but only on a limited basis. In general, your overall activity may be escalated to normal as you progress through this second time period, such that by 6-8 weeks following the date of surgery, you should be back to normal activity. If you take aspirin as a regular medication, it may be resumed at this time.
Finally, call our office one week after your surgery for the results of your biopsy and your next appointment.