US - Canada - UK differences in TURBT / Cystoscopy

Steve sent me some details of the US and Canadian TURBT regime and I have reproduced these below. HK in Canada supplied the Canada details.

I've added Cystoscopy here as well because, in essence, that is what I have to have the biopsies taken but they use the same tool (I believe) in both because it cuts and cauterises the procedure is similar.

Here is the US:

In the US you go to the hospital as an "outpatient" and do not spend the night. After the surgery you get 1 hour of Chemo (no salt wash) and 3 hours of recovery, then you are sent home with a catheter. You take codeine (lortabs) for a couple of days, and on the morning of the third day, you remove the catheter yourself. By the fourth day you are back to mostly normal movement and should have bladder control with only minimal discomfort.

Here is the Canadian:

In Canada, you need to not eat after Midnight. Next day you need to go 3 hours before the Surgery, they put IV and Antibiotic through IV. Once the Surgery is done, 2 tubes are attached in Catheter ,one to clean your bladder with Sodium Chloride and the other to void through Catheter. Also IV is attached to. Doctor comes and checks in the morning (after 18 to 24 hours), and informs the nurse to remove IV and catheter.

Need to Void in the bottle to check how much urine comes out. Once it okay then you need to go home. If it is not enough then doctor decides either you have a Catheter go home or you stay in the Hospital. Sometimes doctor will come after couple of hours after surgery and he will give Chemo. ( doctors Decision). I hope this will help you .

Doctor will give you antibiotic once you are released from the Hospital.2 to 3 day is very painful. If you bleed a lot , need to go to Emergency that what doctor tells the patient. After 2 to 3 weeks result is given about the Tumour.

Here is the UK:

Typical no eating routine - if you go in for an afternoon operation then no food after 7:30, you can drink small quantities of water up to 11:00 and you go to the Hospital to arrive at 11:30. They take you to a pre-theatre area, get you kitted up into one of those gowns for operations, get your DVT Stockings to put on and you look a right Charlie! They do the usual tests and operations start at 2 pm. You can go any time from 2 to about 4 or 4:30.

You are wheeled to theatre - you would have signed consent forms and they go through a check list. You go to a prep room where they insert a cannula into the back of your hand and it depends whether or not you are awake or not whether they wire you up to the ECG and BP cuff etc. Sometimes it has been done before the cannula sometimes they must do it after they knock you out.

If a TURBT you wake up with a catheter inserted with a couple of large bags of washing out fluid and a bag for that to empty into. This is usually a frame based system to the side of the bed. Later you may get a leg bag to use. Often you will have a drip in the back of your hand and be on Oxygen for up to 30 minutes afterwards.

The Catheter stays in for about 36 hours. Certainly all the next day and the morning after that it is taken out before which they give you a jab of antibiotic. The nurse takes a sample from the catheter for analysis and then drains the bulb part holding the catheter in and she withdraws it - you give a few coughs to get it moving out past your prostate. The relief is short lived - see next para!

The first time you pass urine after this is perhaps the most painful thing and after that it gradually gets better. Passing blood for a short time then after two or three weeks the scabs will be ejected.

With a Cystoscopy for biopsies you go through the same routine as above except you do not have the catheter on waking and you maybe just have the drip. You need to pee in jugs to start with so they can monitor input and output (they do that in a TURBT as well). After the first pee which is every bit as painful as the first one noted above, they monitor you for a while. If they are happy you can - potentially - go home on the same day. Normally they monitor you overnight. In general terms with biopsies you don't pass much blood at all and after a few weeks the scabs come off and you pass them.

On both you wake up with a shaved leg - when I asked about that, it is where they ground the machine that cauterises the bladder as it cuts.

If you feel up to it - this short video shows the process of removing a tumour from the Bladder with the cauterising loop. Not for the feint hearted.



I'm not certain I like the idea of DIY catheter removal. I have not had any chemo with my treatments but I know they load you full of stuff at the time of the operation.

Pain relief is normally with Ibuprofen and Paracetamol tablets. They must give you something when you are under as well of course.

Generally results are 2 weeks - sometimes I have waited up to 4 weeks.