Transurethral resection of bladder tumor (TURBT)

A surgery done through the urethra, with no cuts on the skin, to remove a bladder tumor and learn exactly what kind it is and how deep it goes. It is both the first treatment and the key test for bladder cancer.

Also called TURBT, TUR-BT, TURBT surgery, transurethral resection of bladder tumor, bladder tumor resection, bladder tumor removal, scrape the bladder tumor, remove bladder tumor through the urethra

Where: Hospital operating room or outpatient surgery center
Anesthesia: General anesthesia (fully asleep) or spinal anesthesia (numb from the waist down)
Time in the room: 30 to 90 minutes
Hospital stay: Usually home the same day; one night after a large tumor or heavy bleeding
Going home with: Sometimes a urinary catheter for 1 to 3 days
Back to normal: 1 to 2 weeks
Back to work: 2 to 5 days for desk work; about 2 weeks for heavy physical work

See the steps

LiningBladder muscleTumorTrigoneLeft ureter opening

Where it happens. The highlighted part is what this procedure treats.

Overview

A TURBT is how bladder tumors are removed and diagnosed. Your surgeon passes a thin telescope called a resectoscope through the urethra (the tube that carries urine out of the body) into the bladder. A small electric wire loop at its tip shaves the tumor away in small pieces. There are no cuts on your skin.

The surgery has two jobs. The first is to remove every tumor that can be seen. The second is to give the pathologist (the doctor who studies tissue under a microscope) enough tissue, including a piece of the deeper muscle wall, to say what kind of tumor it is, how aggressive the cells look, and how deep it has grown. Those answers decide everything that comes next.

Most bladder tumors found this way have not grown into the bladder muscle. For these, TURBT followed by regular checkups, and often medicine placed into the bladder, is the main treatment. If the tumor has reached the muscle, the TURBT gives the diagnosis, and the plan moves to chemotherapy, removal of the bladder, or radiation.

Most people go home the same day. Blood in the urine on and off for up to 2 weeks is expected. The pathology results usually come back in about a week.

The parts of your body involved

The bladder is a stretchy, muscular bag that stores urine. Its inside is covered by a thin lining of cells called the urothelium, which is where almost all bladder cancers start. Under the lining is a thin layer of connective tissue, then a thick layer of muscle, then fat. How deep a tumor reaches through these layers is the most important fact about it. Low in the bladder is a triangle-shaped area called the trigone, where the two ureters (the tubes that bring urine down from the kidneys) open into the bladder.

Lining (urothelium)
The inner surface of the bladder, a few cells thick. Most bladder tumors start here and grow outward like small plants, or spread flat along it.
Connective layer (lamina propria)
A thin layer of tissue and small blood vessels just under the lining. A tumor that grows into it is called T1.
Bladder muscle (detrusor)
The thick muscle that squeezes to empty the bladder. Cancer that reaches it is called muscle-invasive and needs stronger treatment.
Trigone and ureter openings
The low triangle where urine from each kidney enters the bladder. Tumors near these openings are removed with extra care so the openings do not scar shut.
Urethra
The tube from the bladder to the outside. It is the path the resectoscope travels. In men it is long and passes through the prostate; in women it is short and straight.

Why it’s done

TURBT is recommended whenever a growth is seen in the bladder, usually during a cystoscopy done because of blood in the urine, or on a scan. It is also used when tumors come back during follow-up, and as a planned second surgery when the first one leaves questions unanswered.

To find out what the growth is
Only tissue can show whether a growth is cancer, its grade (low or high, meaning how abnormal the cells look), and its stage (how deep it goes). Scans and urine tests cannot answer these questions on their own.
To remove the tumor
For tumors that sit on the surface or in the connective layer, removing them completely is the main treatment.
To check whether the muscle is involved
A sample of the muscle wall under the tumor tells your team whether the cancer is still early or has grown deeper. This decides whether you need bladder medicines, or chemotherapy and bigger surgery.
To stop bleeding
Bladder tumors bleed easily. Removing them usually stops the blood in the urine.
A second look when needed
If the first TURBT finds a T1 tumor, if no muscle was in the sample, or if a large tumor could not be fully removed, guidelines recommend a repeat TURBT, usually within about 2 to 6 weeks. It often finds leftover tumor and makes sure deeper cancer is not missed.
Tumors that come back
Bladder tumors often return. A new tumor seen on a follow-up cystoscopy is usually removed the same way.

Other options

Office fulguration for small repeat tumors
For a person with a known history of low-grade tumors, a small new tumor can sometimes be burned (fulgurated) or treated with a laser during an office cystoscopy with numbing gel. This is not used for a first tumor or one that looks high grade, because it does not give a good tissue sample.
Watching very small low-grade tumors
For some people with a history of small low-grade tumors, a tiny new spot can be watched with regular cystoscopy instead of being removed right away. This is a shared decision based on how the tumor looks and how it behaves over time.
Chemoablation with mitomycin gel
For some low-grade tumors that keep coming back, a gel form of mitomycin (a chemotherapy) placed into the bladder in clinic can treat the tumors without surgery. It suits only certain people, and a TURBT is still needed for a first diagnosis.
Removing the bladder
For a new tumor, nothing replaces TURBT, because the diagnosis and stage come from it. Bladder removal is considered only after TURBT shows muscle-invasive cancer or a very high-risk early cancer.
Not treating
Leaving a bladder tumor alone is rarely a safe choice. Even low-grade tumors keep growing and bleeding, and the true type cannot be known without tissue. For someone too frail for anesthesia, a smaller procedure to control bleeding may be discussed.

In the operating room, step by step

Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.

Leg supportsAnesthesia teamSurgeonVideo screen

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1. Going to sleep and positioning

In the operating room you get general anesthesia or a spinal. Once you are comfortable, your legs are placed in padded stirrups, the same position as for a pelvic exam. The area is cleaned and covered with sterile drapes.

More detail

For tumors on the side walls of the bladder, many surgeons ask for full muscle relaxation. A nerve close to those walls (the obturator nerve) can make the leg jump when the electric loop is used nearby, and relaxation prevents this.

In the operating room you get general anesthesia or a spinal. Once you are comfortable, your legs are placed in padded stirrups, the same position as for a pelvic exam. The area is cleaned and covered with sterile drapes.
More detail
For tumors on the side walls of the bladder, many surgeons ask for full muscle relaxation. A nerve close to those walls (the obturator nerve) can make the leg jump when the electric loop is used nearby, and relaxation prevents this.
With you asleep and relaxed, your surgeon gently feels the bladder between one hand on the lower belly and a finger in the rectum or vagina. This is called an exam under anesthesia. A tumor that feels thick or fixed in place can be a sign of deeper growth.
More detail
The exam is often repeated at the end of the surgery. It adds information to the pathology report when the team decides on the stage.
The resectoscope, a straight metal telescope with a camera, is lubricated and passed through the urethra into the bladder. Sterile fluid runs through it to fill the bladder gently, so the folds of the wall open up and can be seen.
More detail
In men the urethra is long and curves through the prostate, so the surgeon guides the scope under direct vision. In women the urethra is short and straight.
Before anything is cut, your surgeon looks over every part of the lining with angled lenses: the dome, the side walls, the back wall, the trigone and both ureter openings. The size, number and location of each tumor are recorded, often with photos. Many tumors look like small sea plants waving in the water.
More detail
Flat red patches can be carcinoma in situ (CIS). Your surgeon may take small biopsies of suspicious areas, and in men sometimes of the urethra inside the prostate, to look for hidden CIS.
If the blue light liquid was placed before surgery, tumor cells have absorbed it. When the surgeon switches the light, tumors glow pink against a blue background. This can reveal small or flat tumors that are hard to see in normal white light.
More detail
Studies show that blue light finds more tumors and lowers the chance of an early return. It is used most for first tumors, high-risk tumors and suspected CIS, where the equipment is available.
Your surgeon brings the wire loop to the edge of the tumor. An electric current runs through the thin wire, so it cuts tissue cleanly and seals small blood vessels at the same time. You feel nothing.
The loop is drawn back toward the scope in smooth strokes, each one shaving off a curl of tissue. These pieces, called chips, float in the fluid. The tumor is removed piece by piece until the area is level with the bladder wall.
More detail
Some surgeons remove a suitable tumor in one piece, called en bloc resection, using the loop, a laser or a special electrode. One intact piece can make the depth easier for the pathologist to judge.
Next, your surgeon takes deeper tissue from the base where the tumor grew, including some of the bladder muscle. This is the most important sample of the operation. It tells the pathologist whether cancer has reached the muscle.
More detail
The base is often sent in a separate labeled container so the pathologist knows exactly where it came from. The wall can be only a few millimeters thick in places, so the surgeon goes deep enough to reach muscle without going through the wall.
The loop is switched to a gentler current to seal bleeding points on the raw base. The chips are washed out of the bladder with a squeeze bulb or syringe and sent to the lab. Your surgeon takes one more careful look around to make sure nothing was missed.
If the tumor was large or there was bleeding, a soft tube called a Foley catheter is placed through the urethra into the bladder. A small balloon holds it inside. Sometimes fluid is run in and out through a three-channel catheter to keep clots from forming. Many people with small tumors go home without a catheter.
For tumors that look low grade, your team will often place one dose of chemotherapy, usually gemcitabine or mitomycin, into the bladder within 24 hours of surgery, often in the recovery room. It stays in for about 1 hour and is then drained. It kills loose tumor cells that could otherwise settle on the wall and grow.
More detail
This single dose lowers the chance of an early return of low-grade tumors. It is skipped if the bladder wall may have been punctured, if there is heavy bleeding, or when the tumor clearly looks muscle-invasive. Because the medicine stays inside the bladder, body-wide side effects are rare.
In the lab, the pathologist reports the grade (how abnormal the cells look) and the stage (how deep the tumor reached). Ta means the tumor grows only on the lining. T1 means it has grown into the connective layer under the lining. CIS means flat, high-grade cancer cells lying on the lining. T2 means the cancer has reached the muscle.
More detail
Low-grade Ta tumors often come back but rarely become dangerous. High-grade tumors, T1 tumors and CIS are more likely to grow deeper, so they are usually treated with BCG and watched closely. T2 cancer needs a stronger plan, such as chemotherapy followed by bladder removal, or chemotherapy with radiation.

After the operation

Right afterward

Waking up
You wake up in the recovery room within 30 to 60 minutes. A strong urge to urinate or a burning feeling is common, even when the bladder is empty. It is the healing area or the catheter, and it eases with medicine and time.
If you get the chemotherapy dose
The medicine stays in your bladder for about 1 hour, then is drained through the catheter. The nurses wear gloves and gowns while handling it, which is standard practice.
Passing urine
If you have no catheter, you will usually be asked to pass urine before you go home. Pink or red urine is expected.
Overnight stay, if needed
After a large resection or if bleeding is heavier, you may stay one night with fluid running through the catheter to keep clots away. The catheter usually comes out within 1 to 3 days, sometimes in the clinic.
Pain control
Most people need only acetaminophen. Bladder spasms, sudden cramping urges to urinate, can be eased with a medicine such as oxybutynin. Phenazopyridine eases burning and turns urine bright orange.

At home

Blood in the urine
Pink urine on and off for 1 to 2 weeks is normal. Around 10 to 14 days after surgery, the scab on the healing area falls off and the urine can turn red again for a day or two. Drink extra water and rest. Call if you pass clots or cannot urinate.
Burning and urgency
Burning, frequent urination and sudden urges are common for a few days and can last up to 2 weeks after a larger resection.
Fluids
Drink enough to keep your urine light pink to clear, often about 8 to 10 cups a day, unless you have a heart or kidney condition that limits fluids. Cut back on caffeine and alcohol, which can irritate the bladder.
Bowels
Avoid straining, which can restart bleeding. Use a stool softener if you are taking opioid pain medicine or tend to be constipated.
Activity and lifting
Walking is encouraged. Avoid lifting more than about 10 to 15 pounds, hard exercise, bike riding and heavy yard work for about 2 weeks, or longer after a large resection.
Catheter care
If you go home with a catheter, keep the bag below your bladder, clean where the tube enters your body with soap and water daily, and use the larger bag at night. The catheter usually comes out in a few days.
Driving
Most people can drive in 1 to 2 days, once they are off opioid pain medicine and can move and brake comfortably.
Showering and baths
Showers are fine the next day. Ask your team before taking a bath or swimming, especially if you have a catheter.
Sex
Wait about 1 to 2 weeks, or until the bleeding settles. If you had chemotherapy in your bladder, follow the specific instructions you were given.
Blood thinners
Restart them only when your surgeon says, often after a few days depending on bleeding.

Recovery timeline

Day 0
Surgery and home
Most people go home a few hours after surgery, with or without a catheter. Pink urine and burning are expected.
Days 1 to 3
Catheter out, if you had one
Burning and urgency are strongest in the first few days. Most people are up and about at home.
About 1 week
Pathology results
Your team shares the grade and stage, your risk group, and the next step: checkups only, medicine in the bladder, a repeat TURBT, or further treatment.
Days 10 to 14
The scab comes off
A short return of red urine is common as the healing area sheds its scab. It usually clears with extra fluids in a day or two.
Weeks 2 to 6
Next treatment, if needed
A repeat TURBT is often done 2 to 6 weeks after the first when it is recommended. BCG or a chemotherapy course usually starts 2 to 4 weeks after surgery, once the bladder has healed.
3 months
First checkup cystoscopy
A quick office cystoscopy looks for any new tumor. Urine tests are often done at the same visit.
First 2 years
Close checkups
Cystoscopy every 3 to 6 months, depending on your risk group. Most returns of tumor happen in this window.
Long term
Lifelong watch
If all stays clear, the visits spread out, often to once a year. People with high-risk tumors also get regular imaging of the kidneys and ureters.

What it feels like

TURBT is usually a short, quiet surgery, and most people say the physical recovery is easier than they feared. The harder part for many is the waiting: for the surgery, for the pathology result, and later for each checkup. Knowing what is normal makes those days easier.

Hearing the word tumor
Many people feel shock or fear when they first hear there is a growth in the bladder, often after seeing blood in the toilet. It is common to imagine the worst before any facts are in.
What helpsMost bladder tumors found this way have not reached the muscle and are very treatable. Write down your questions, bring someone to visits, and ask your team what they expect based on how the tumor looked.
The night before
Trouble sleeping and worry about anesthesia are common. Some people feel embarrassed about the position or the scope.
What helpsThe surgery is done every day in every hospital. You are asleep or numb, draped and covered, and the team is focused only on doing it well.
Waking up
A strong urge to urinate, burning at the tip of the urethra, or cramping in the lower belly are the most common feelings. A catheter can make it feel like you need to go all the time.
What helpsTell your nurse. Bladder spasm medicine and phenazopyridine help quickly. The feeling eases over the first day or two.
The first time you urinate
Seeing pink or red urine and feeling a sharp burn can be scary.
What helpsThis is expected. Drink water steadily through the day. If the color looks like ketchup or you pass thick clots, call.
Waiting for the pathology
The days until results can feel long. Some people search online and find frightening numbers that may not apply to them.
What helpsAsk before you leave how and when you will get the results. Your own grade and stage matter far more than general statistics.
Around day 10 to 14
Just as things seemed fine, red urine can return when the scab comes off. Many people worry the tumor is back.
What helpsThis is a normal part of healing. Rest, drink more and avoid straining. Call if it does not lighten within a day or two or if you pass clots.
Before each checkup
Many people feel a wave of worry before every follow-up cystoscopy, sometimes for years.
What helpsThis is a normal response. Planning something pleasant after each visit helps some people. Finding a small tumor early is the point of the checkups, and small tumors are easy to treat.

How well it works

A successful TURBT removes all visible tumor and gives a clear answer about grade and stage. Your team then places you in a risk group (low, intermediate or high risk) based on the grade, stage, size, number of tumors and whether it is a first or repeat tumor. That risk group guides what comes next.

Complete removal
The goal is no visible tumor left at the end. Your surgeon will tell you whether everything could be removed in one session.
A trustworthy stage
Muscle in the sample means the stage can be trusted. If muscle was missing in a high-grade tumor, or the tumor was T1, a repeat TURBT is usually advised.
Your risk group
Low-risk tumors are usually followed with checkups alone. Intermediate-risk tumors often get a course of medicine in the bladder. High-risk tumors usually get BCG. Muscle-invasive cancer needs a different treatment plan.
Follow-up cystoscopy
The first check is usually about 3 months after surgery. How often you are checked after that depends on your risk group.
Tumors often come back
Bladder tumors return in many people, often half or more over the following years, especially low-grade ones. Most returns are found early on a checkup and are small and easy to treat.

Risks

Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.

Common

Blood in the urine

Expected in almost everyone for days, and on and off for up to 2 weeks. It is usually light pink and clears with fluids.

Burning, urgency and frequent urination

The healing area irritates the bladder for a few days to 2 weeks. Medicines can ease it.

Bladder spasms

Sudden cramping and an urge to urinate, especially with a catheter. These settle as the bladder heals.

Bleeding when the scab falls off

A short return of red urine around 10 to 14 days after surgery. Usually settles with fluids and rest.

Less common

Urinary tract infection

Fever, worsening burning, or cloudy, foul-smelling urine. Treated with antibiotics.

Clots or heavier bleeding

Clots can block the urethra so urine cannot get out. A catheter is placed to wash them out. A return to the operating room to stop bleeding is uncommon.

A hole in the bladder wall (perforation)About 1 to 5 in 100 people

Can happen when a tumor is removed deeply or the wall is thin. Most holes are small and heal with a catheter left in for several days. A hole that opens into the belly may need surgery to repair.

Trouble urinating afterward

More common in men with an enlarged prostate or after spinal anesthesia. Usually managed with a catheter for a few days.

Leftover tumor

Some tumor can remain after a first TURBT, especially with large or many tumors. This is why a repeat TURBT is advised for certain tumors.

Rare

Narrowing of the urethra

Scar tissue can form weeks to months later and cause a weak stream. It can be treated.

Scarring of a ureter opening

When a tumor sits on or near a ureter opening, healing can narrow it and block drainage from that kidney. This is checked for and can be treated with a stent or surgery.

Blood clots in the legs or lungs

Rare after this short surgery. Walking soon after surgery helps prevent them.

Fluid absorption

Absorbing too much of the rinsing fluid into the bloodstream is very rare with modern equipment that uses salt water.

Call your care team or go to the emergency room if

You cannot pass any urine for 4 hours or more, or your lower belly feels swollen and painful.
Fever of 101°F (38.3°C) or higher, or shaking chills.
Urine that looks like ketchup or is thick with clots, or bleeding that does not lighten after a few hours of rest and extra fluids.
Your catheter stops draining for more than 1 hour, even after you check for kinks.
Severe or worsening belly pain or swelling, especially with nausea or vomiting.
Pain, swelling or warmth in one leg.
Sudden shortness of breath, chest pain, or fainting: call 911.

Questions to ask your surgeon

How many tumors did you see, how big are they, and where are they?
Do you expect to remove everything in one surgery?
Will you use blue light during my surgery?
Will I get a dose of chemotherapy in my bladder after surgery?
Will I go home with a catheter, and for how long?
When and how will I get the pathology results?
What are my grade, stage and risk group?
Will I need a repeat TURBT?
Will I need BCG or chemotherapy in my bladder afterward?
How often will I need checkup cystoscopies, and for how long?
Do I need imaging of my kidneys and ureters?
What should I do about my blood thinners before and after surgery?

Words you may hear

TURBT: Transurethral resection of bladder tumor: removing a bladder tumor with a scope passed through the urethra.
Resectoscope: A straight telescope with a camera and a small electric wire loop used to cut and seal tissue.
Urothelium: The lining of the bladder, ureters and kidneys, where most bladder cancers begin.
Lamina propria: The thin connective layer just under the bladder lining.
Detrusor muscle: The thick muscle layer of the bladder wall.
Grade: How abnormal the cancer cells look. High-grade cells are more likely to grow and spread than low-grade cells.
Stage: How deep the cancer has grown, from the lining (Ta) to the connective layer (T1) to the muscle (T2) and beyond.
Carcinoma in situ (CIS): Flat, high-grade cancer cells lying on the bladder lining. It is not a raised tumor but needs treatment, usually with BCG.
Non-muscle-invasive bladder cancer: Cancer that has not reached the bladder muscle: Ta, T1 and CIS.
Muscle-invasive bladder cancer: Cancer that has grown into the bladder muscle (T2 or deeper). It needs a stronger treatment plan.
Recurrence: A tumor coming back after it was removed.
Progression: A tumor coming back at a higher grade or a deeper stage.
Fulguration: Burning a small tumor or bleeding spot with an electric tip.
Blue light cystoscopy: Using a liquid placed in the bladder and a special blue light that makes tumors glow pink.
Repeat TURBT: A planned second resection a few weeks after the first, to remove leftover tumor and confirm the stage.

Common questions

Will I have any cuts or scars?

No. The whole surgery is done through the urethra, the natural opening you urinate through.

Does TURBT cure bladder cancer?

For many early tumors, TURBT removes all of the cancer. Because bladder tumors often come back, it is followed by regular checkups and often by medicine placed in the bladder. If the cancer has reached the muscle, TURBT is the first step of a larger plan.

Why might I need a second TURBT so soon?

If the first surgery found a T1 tumor, did not include muscle, or could not remove a large tumor completely, a second look finds leftover tumor in many people and makes sure deeper cancer is not missed. It helps your team choose the right treatment.

Why does my urine turn red again after it had cleared?

Around 10 to 14 days after surgery, the scab on the healing area falls off. A day or two of red urine is common. Drink more water and rest. Call if you pass clots, cannot urinate, or it does not lighten.

Is my urine dangerous to my family after the chemotherapy dose?

The single dose is drained before you leave the recovery area. Your team may still ask you to sit to urinate, flush twice and wash your hands well for the rest of that day. Follow the instructions you are given.

Does stopping smoking still matter now that I have cancer?

Yes. People who stop smoking have fewer bladder tumors come back than people who keep smoking. It also lowers the risk of surgical problems.

When can I travel?

Short car trips are usually fine after a few days. Ask before longer trips or flights in the first 2 weeks, since that is when delayed bleeding can happen.

Sources this page draws on

American Urological Association and Society of Urologic Oncology, Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline
European Association of Urology, EAU Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and CIS)
SWOG Cancer Research Network, S0337 trial: a single dose of gemcitabine in the bladder right after TURBT (Messing and colleagues, JAMA) (2018)
American Cancer Society, Bladder Cancer
National Cancer Institute, Bladder Cancer
Urology Care Foundation, Bladder Cancer

Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.

Transurethral resection of bladder tumor (TURBT)

Overview

The parts of your body involved

Why it’s done

Other options

Getting ready

2 to 4 weeks before

The week before

The day before

The morning of surgery

In the operating room, step by step

1. Going to sleep and positioning

After the operation

Right afterward

At home

Recovery timeline

What it feels like

Hearing the word tumor

The night before

Waking up

The first time you urinate

Waiting for the pathology

Around day 10 to 14

Before each checkup