Bladder tumour removal (TURBT)
A telescope operation through the water pipe to remove a tumour from inside the bladder, both to treat it and to find out what it is.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A TURBT removes a bladder tumour through a telescope, both to treat it and to find out its type, grade and depth.
- It is the main treatment for non-muscle-invasive bladder cancer, often with a single dose of chemotherapy into the bladder afterwards.
- Bladder tumours can come back, so regular telescope check-ups (surveillance) are usually needed, and a second TURBT is sometimes required.
- The full picture only comes from the laboratory results; if the cancer has invaded the muscle, more major treatment is usually discussed.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Removes the visible tumour from the bladder
People with an active urine infection, which should usually be treated before the procedure.
You recover from the anaesthetic, often with a catheter draining the bladder. Expect blood-stained urine. You will usually need someone to take you home...
Clear advice on blood in the urine, fluids, and catheter care, with a named contact.
You recover from the anaesthetic, often with a catheter draining the bladder. Expect blood-stained urine. You will...
Blood in the urine and mild stinging settle. Drink plenty of fluids to flush the bladder, and avoid heavy...
You gradually return to normal activities. The laboratory results on the removed tissue usually come back within...
Depending on the results, you may need a single follow-up, ongoing surveillance cystoscopies, a second TURBT, or...
What is a bladder tumour removal (TURBT)?
A transurethral resection of bladder tumour, or TURBT, is an operation to remove a growth (tumour) from the inner lining of the bladder. It is done with a telescope passed up the water pipe (urethra), so there are no cuts on the outside of the body.
A TURBT does two jobs at once. It treats the tumour by scraping it away, and it provides tissue for the laboratory to examine. The laboratory result tells the team what type of tumour it is, how abnormal the cells look (the grade) and how deeply it has grown (the stage). This is the key information used to plan any further treatment.
Many bladder tumours are non-muscle-invasive, meaning they have not grown into the deeper bladder muscle. TURBT is the main treatment for these, often followed by a single dose of chemotherapy placed into the bladder soon after the operation to lower the chance of the tumour coming back. After a TURBT, people usually need regular telescope checks of the bladder (surveillance cystoscopy), because these tumours can return.
It is important to understand that a TURBT removes what the surgeon can see and reach. Sometimes a second TURBT is needed a few weeks later to be sure the tumour is fully removed and correctly staged, and if the cancer has grown into the muscle, more major treatment is usually needed.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Standard (white-light) TURBT
The tumour is removed using a telescope and an electrical loop under normal lighting. The most common technique, used to treat and stage the tumour.
Enhanced (blue-light or narrow-band) TURBT
A dye or special light is used to make some tumours show up more clearly, which can help find flat or hard-to-see disease. Not used everywhere, and your surgeon will explain...
Single dose of chemotherapy into the bladder
For suitable tumours, a single dose of chemotherapy is placed into the bladder soon after the TURBT to reduce the chance of the tumour returning. It is given through the...
Second (re-look) TURBT
A repeat TURBT a few weeks later for higher-risk tumours, to make sure the tumour is fully removed and accurately staged before deciding on further treatment.
Preparing for your procedure
- See a urologist, who will explain why the TURBT is needed and what it can and cannot tell you.
- Tell the team about all medicines, especially blood thinners, as these may need adjusting before the procedure.
- Have a urine test beforehand, as an active infection usually needs treating first.
- Follow fasting instructions for the anaesthetic, and arrange transport home as you will not be able to drive that day.
- Ask whether a single dose of chemotherapy into the bladder is planned afterwards.
- Plan for a catheter for a short time and for blood in the urine for a few days after the operation.
- Arrange for someone to stay with you for the first 24 hours if you go home the same day.
What happens
The procedure is done under a general or spinal anaesthetic. A telescope (resectoscope) is passed up the urethra into the bladder, which is filled with fluid so the surgeon can see the lining clearly.
Using an electrical loop or similar instrument, the surgeon removes the tumour in pieces and takes samples of its base, then seals any bleeding points. The removed tissue is sent to the laboratory. For suitable tumours, a single dose of chemotherapy may be put into the bladder through the catheter shortly afterwards.
The operation usually takes around 15–60 minutes. A catheter is often left in for a short time to drain the bladder and flush out blood. Many people go home the same day, while some stay one or two nights.
Is this procedure right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- People with an active urine infection, which should usually be treated before the procedure.
- Those not fit enough for an anaesthetic, until this is assessed and optimised.
- Situations where the cancer is already known to need different first treatment, as decided by the specialist team.
- People whose blood-thinning medicines cannot be safely managed around the procedure without further planning.
Delay or rearrange if…
- You currently have a urine infection.
- Your blood-thinning medicine needs adjusting before the procedure.
- You are unwell or have another condition that needs stabilising before an anaesthetic.
- Pre-operative tests or staging scans are still needed to plan care.
Alternatives to discuss
- Flexible cystoscopy and biopsy alone, where only a sample is needed rather than full removal.
- Imaging and surveillance in selected low-risk situations, as advised by the specialist.
- For confirmed muscle-invasive cancer, more major treatment such as bladder removal or chemo-radiotherapy.
- Having the procedure on the NHS rather than privately, as it is a standard NHS treatment.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Removes the visible tumour from the bladder
- Provides tissue so the type, grade and depth of the tumour can be determined
- Guides whether further treatment is needed and which treatment is best
- A single dose of chemotherapy afterwards can reduce the chance of some tumours returning
- Done through the water pipe, so there are no external cuts
Risks & complications
- Blood in the urine for a few days, sometimes with small clots
- A mild burning or stinging feeling when passing urine for a short time
- Needing a catheter for a short period after the operation
- Mild discomfort or a frequent urge to pass urine while the bladder heals
- A urine infection needing antibiotics
- Heavier bleeding or clots that block the catheter and need flushing
- Temporary difficulty passing urine after the catheter is removed
- A blood clot in the leg (deep vein thrombosis)
- A hole made in the bladder wall (perforation), which may need a catheter for longer or, rarely, an operation to repair
- Heavy bleeding needing a blood transfusion or further procedure
- Scarring of the urethra causing a narrowing over time
- The tumour being more advanced than expected, needing further treatment
TURBT is usually well tolerated, but a few specific risks matter. Blood in the urine and mild burning are common (each in more than 1 in 10 people); a urine infection is occasional (between about 1 in 10 and 1 in 50); and a perforation of the bladder is uncommon (less than about 1 in 50) but can mean a longer time with a catheter or, rarely, an operation. The biggest ongoing issue is that bladder tumours can return, so regular surveillance is needed. Ask your surgeon about your follow-up plan and whether a second TURBT will be needed.
Published figures to discuss
Reported complication rates after TURBT vary with the size, number and position of tumours, the patient's health and blood-thinning medicines. The figures below use cautious frequency bands from UK patient information (BAUS and Cancer Research UK) and should be read as general guidance, not a personal prediction. The most important ongoing issue is recurrence, which is why surveillance is needed.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Blood in the urine / mild burning passing urine | Common — more than 1 in 10 | Usually settles within a few days; drinking plenty of fluids helps. | Transurethral resection of bladder tumours (TURBT) — review (PMC)ncbi.nlm.nih.govPublished figure |
| Urine infection | Occasional — between about 1 in 10 and 1 in 50 | Treated with antibiotics; a urine test before the procedure helps reduce this. | Transurethral resection of bladder tumours (TURBT) — review (PMC)ncbi.nlm.nih.govPublished figure |
| Perforation of the bladder | Usually under about 1 in 20 in published series, but small recognised perforations may be reported more often | May need a catheter for longer or, rarely, an operation to repair. | Transurethral resection of bladder tumours (TURBT) — review (PMC)ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Most people recover quickly from a TURBT, but expect some blood in the urine and stinging for a few days, a short time with a catheter, and a wait for the laboratory results that guide what happens next.
- Pink or blood-stained urine for a few days, sometimes with small clots
- Mild burning or a frequent urge to pass urine that settles
- Tiredness for a day or two after the anaesthetic
- Waiting for laboratory results before knowing the full picture
Aftercare
- Drink plenty of fluids in the first days to flush the bladder, unless told otherwise.
- Avoid heavy lifting, strenuous activity and driving as advised after the anaesthetic and while there is bleeding.
- Take any prescribed antibiotics or painkillers as directed.
- Watch for and report signs of a urine infection or heavy bleeding.
- Look after the catheter as instructed if you go home with one, and know how it will be removed.
- Attend the appointment to discuss your results and the follow-up plan.
- Keep all surveillance (check-up) appointments, as bladder tumours can return.
- A urine test arranged beforehand to exclude infection
- Transport home and someone to stay with you for the first 24 hours
- Time off work arranged (often a few days to a few weeks depending on your job)
- Knowing how and when any catheter will be removed
- Knowing the signs of infection, clots or being unable to pass urine
- A clear plan for getting your results and your follow-up checks
Scars and how they heal
There are no external cuts, so there are no skin scars. Inside, the bladder lining heals over a few weeks. Occasionally, repeated procedures or instrument use can cause scarring (narrowing) of the urethra over time, which may need treatment if it affects passing urine.
⚠ Get urgent help if…
- Being unable to pass urine, with a full, painful bladder — seek urgent help
- Heavy bleeding, lots of clots, or your catheter blocking and not draining
- Fever, chills, or burning, smelly or cloudy urine — possible urine infection
- Severe or worsening tummy or pelvic pain
- Calf pain or swelling, or sudden breathlessness or chest pain — possible blood clot, seek urgent help
- Feeling generally very unwell after the procedure
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good immediate result is that the visible tumour is removed and bleeding is controlled. The most important result, though, is from the laboratory: the type, grade and depth of the tumour. This usually takes up to about two weeks and is used to plan any further treatment and follow-up.
A TURBT removes what the surgeon can see and reach, so it cannot guarantee that no tumour remains or that it will not come back. For higher-risk tumours a second TURBT may be advised to be sure of complete removal and accurate staging. If the laboratory shows the cancer has grown into the bladder muscle, more major treatment, such as bladder removal or chemo-radiotherapy, is usually discussed.
Removing the tumour treats the disease that is present, but non-muscle-invasive bladder tumours commonly return over time, and some can progress. This is why regular surveillance cystoscopies are needed, sometimes for years, and why some people have repeat TURBTs or courses of treatment into the bladder. Stopping smoking is one of the most important things you can do to reduce the risk of new tumours.
Related tests, treatments or support
TURBT is often combined with a single dose of chemotherapy placed into the bladder soon after the operation, for suitable tumours, to reduce the chance of recurrence. Depending on the results, it may be followed by a course of bladder instillations (such as BCG or chemotherapy) given over weeks. These decisions are guided by the laboratory findings and the specialist team.
Follow-up & long-term care
You will be given the laboratory results and a follow-up plan, which usually includes regular surveillance cystoscopies to check for the tumour coming back. Higher-risk tumours may need a second TURBT or further treatment. Report blood in the urine, infection or difficulty passing urine between appointments.
- Regular surveillance cystoscopies to watch for the tumour returning.
- Any planned course of bladder instillations (such as BCG or chemotherapy).
- Stopping smoking, which lowers the risk of new bladder tumours.
- Reporting new bleeding or urinary symptoms promptly between check-ups.
Repeat, follow-on and what comes next
- A second (re-look) TURBT is often advised for higher-risk tumours to confirm complete removal and accurate staging.
- Non-muscle-invasive tumours commonly recur, so repeat TURBTs over the years are not unusual.
- If the cancer has invaded the muscle, more major treatment is usually needed.
- Surveillance cystoscopies continue for a long time to catch any return early.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- Clear advice on blood in the urine, fluids, and catheter care, with a named contact.
- A timely appointment to discuss the laboratory results and plan.
- A clear surveillance (check-up) schedule, with reminders.
- Support to stop smoking, which lowers the risk of new tumours.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's fee and the size and number of tumours
- Anaesthetic fee and type (general or spinal)
- Theatre and facility fees, and any overnight stay
- Laboratory analysis of the removed tissue
- A single dose of chemotherapy into the bladder, if given
- Follow-up surveillance cystoscopies, which are needed over time
- Any second TURBT or further treatment depending on the results
- The operating surgeon's fee
- Anaesthetist's fee and the type of anaesthetic
- Theatre and facility fees, and any overnight stay
- Laboratory (pathology) analysis of the tissue
- Whether a single dose of chemotherapy into the bladder is included
- Follow-up appointments and surveillance cystoscopies
- What happens, and who pays, if a second TURBT or further treatment is needed
On the NHS? TURBT is a standard NHS procedure for investigating and treating bladder tumours; private care is sometimes chosen for speed or choice of specialist.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that the full diagnosis comes from the laboratory, not the operation itself.
- Not mentioning that a second TURBT may be needed.
- No clear plan for surveillance and the risk of the tumour returning.
- Not discussing the single dose of chemotherapy into the bladder, where it is appropriate.
Marketing red flags
- Implying the tumour is definitely benign or cured before the laboratory results.
- Describing the procedure as completely without risks.
- Not mentioning the need for ongoing surveillance or possible repeat procedures.
- Glossing over what happens if muscle-invasive cancer is found.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What did you see, and do you think this is likely to be cancer?
- When will my laboratory results be ready and how will I get them?
- Will I have a single dose of chemotherapy into the bladder afterwards?
- Will I need a second TURBT, and why?
- What will my surveillance (check-up) schedule be?
- What does it mean for my treatment if the tumour has grown into the muscle?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my procedure, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this procedure not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a TURBT a treatment, a test, or both?
Is it available on the NHS?
How long will I have blood in my urine?
Will I need a catheter?
Why might I need a second TURBT?
Will the tumour come back?
What if it has spread into the muscle?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: Cancer Research UK — Transurethral resection of bladder tumour (TURBT) BAUS — Bladder tumour resection (patient leaflet) NHS England — Guidelines for the management of bladder cancer Transurethral resection of bladder tumours (TURBT) — review (PMC) Bladder perforation during TURBT — clinical series (PMC)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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