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Transurethral Resection (TUR) of Bladder Tumor

Transurethral Resection (TUR) of Bladder Tumor

What is Transurethral Resection of Bladder Tumor?

Why is TUR of Bladder Tumor recommended for some patients, while others need bladder removal?

Why is a repeat TUR biopsy often recommended?

What are the benefits of seeking treatment at the Dilanyan Clinical Center for patients with bladder cancer?

- It is known that a large number of patients with suspected bladder tumor are recommended for TUR. 

What is this?

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Doctor Dilanyan

Let's imagine a clinical scenario, quite common, by the way. Let's suppose a patient comes to the outpatient clinic complaining of blood in the urine. An ultrasound is performed, and the report reads, literally: 'volume formation of such-and-such size in the bladder.' Both the treating physician and the patient are faced with several crucial questions: what is this voluminous formation, bladder cancer, or a benign polyp? If it's cancer, what stage is it, and how do we treat the patient?

To answer all these questions, we need to perform the removal of the bladder tumor and its histological examination. It's important to understand a simple truth: the stage of bladder cancer depends on the extent of tumor invasion into the organ wall. That's why we take a special instrument, pass it through the urethra, excise the tumor, cut out the underlying part of the bladder wall, and send all excised tissue for histological examination. Thus, TUR- transurethral resection - is an operation to remove a bladder tumor through the urethra. Naturally, all this is done under anesthesia.

It's important to know!

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Blood in urine
One of the manifestations of bladder cancer is the appearance of blood in the urine. If you notice even a slight discoloration of urine with blood, immediately make an appointment with an oncologist-urologist.
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Early stages
Early detection of bladder cancer allows for organ-preserving surgery - transurethral resection of the bladder tumor.
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Late stages
In cases of late-stage detection, cystectomy - removal of the bladder - may be necessary. In such cases, we reconstruct the bladder from a section of the intestine."

Transurethral resection of the bladder tumor

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play icon Transurethral resection of the bladder tumor

Transurethral resection of the bladder tumor (TURBT) is a minimally invasive method for removing growths. Using a special instrument called a resectoscope, the surgeon accesses the bladder through the urethra and, using plasma, literally cuts out the tumor. The choice of clinic with modern equipment is important: if visualization allows for the detection of even the smallest remnants of the tumor, the procedure's effectiveness will be higher.

—Can you explain why in some cases transurethral resection of the bladder tumor (TURBT) is a curative method and helps patients, while in other cases, after TURBT, you recommend the removal of the bladder?"

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TUR biopsy

— Once again, it depends on the stage of the tumor. If, upon histological examination, we see that the tumor is confined to the mucous membrane of the bladder, i.e., we are dealing with stage 1 bladder cancer, then we can limit ourselves to TUR, intravesical BCG therapy, or chemotherapy and achieve a cure for bladder cancer. However, if we see that the tumor penetrates into the muscle layer, i.e., this is already stage 2 bladder cancer, then it is possible to cure the patient, unfortunately, only by removing the organ – radical cystectomy. That's why transurethral resection of the bladder tumor (TURBT) is often called TUR biopsy.

— Why do some patients require repeat TURBT? After all, if the tumor is completely removed, one should be at ease?

— Unfortunately, statistics are relentless. At the Dylanyan Clinical Center, we adhere to the standards of providing oncological care according to the recommendations of the European Association of Urology. Unfortunately, it has been proven that residual tumors were detected in 33-53% of patients after transurethral resection of stage T1 tumors. That's why, 6-8 weeks after the initial procedure, we invite the patient for a second TURBT.

Cystoscopy is performed, tissue is taken from the site where the tumor was previously located, and the entire mucosa of the bladder is evaluated. Minimal changes serve as a reason for repeat biopsy. It has been shown that performing a repeat TUR increases the recurrence-free survival in patients with stage 1 bladder cancer. That's why we recommend and even insist on repeat TUR in these patients.

— What are the advantages of seeking treatment at the Dylanyan Clinical Center for patients with bladder cancer?

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— I am proud to say that we have managed to assemble a team of like-minded doctors with solid oncological training. Understanding perfectly well that no tumor, especially aggressive bladder cancer, likes to wait, we perform primary diagnostics within 1-2 days. The patient is ready for TURBT within a day after coming to us.

Given that in our country, we often encounter delays in examinations, queues, in short, a waste of time. For comparison: histological examination takes us 3 working days, not 10-12. Is this important? It simply means that if our patient is found to have stage 2, 3, or 4 tumors, they will be operated on 7-9 days earlier. This "just" gives my patient a better chance of recovery.

Dr. Oganes E. Dilanyan
Urology-oncology surgeon, Ph.D. of Medical Sciences
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