Before surgery you should avoid eating food or liquids for at least eight hours before coming to the hospital. Important medicines can be taken with a sip of water. If you take aspirin or other blood thinners it is best to not take them for the week before the procedure. Please have someone who can drive come with you because generally it is safe to leave the hospital the same day, but it is not safe to drive after having anesthesia.
During surgery you will have anesthesia so there should be no pain. The cystoscope is inserted through the urethra into the bladder, where the tumor(s) is seen. The tumor is removed with a tiny grasper or electocautery, or destroyed with the laser, and the specimen sent for biopsy.
We carefully remove all of the tumor plus a margin of normal tissue. Bladders vary in thickness, but normally there is sufficient muscle in the wall of the bladder to allow us to remove all of the tumor and biopsy the underlying muscle. This is important to make sure that tumor does not invade the muscle. We take care to avoid dissecting all the way through the bladder, but this can happen, especially when the tumor goes deep into the wall of the bladder. When all of the tumor is removed a catheter is typically placed in the bladder and a medicine given to prevent seeding or implantation of tumor cells in the bladder.
After surgery the catheter will generally be removed shortly after you wake up. When you are awake and feeling well you can go home. We like to be sure that you will not have excessive bleeding, so we try to cauterize all blood vessels at the time of surgery. Some bleeding after the procedure, however, is expected. You should notify us if you have heavy bleeding with clots, difficulty urinating, fever or chills. You can expect to have mild burning of urination and frequency. Drinking lots of fluids will generally lessen the burning.
Created: 3/15/2005