Transurethral resection of bladder tumor
Anesthesia type GA or Neuraxial
Airway ETT/LMA (if GA)
Lines and access PIV x 1
Monitors Standard
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative


A transurethral resection of bladder tumor (TURBT) is an endoscopic procedure used to diagnose, stage, and treat early tumors of the bladder. A resectoscope is passed into the bladder via the urethra and used to remove visible tumor.

Preoperative management

Patient evaluation

System Considerations
Neurologic
Cardiovascular
Respiratory
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Labs and studies

Operating room setup

Patient preparation and premedication

Regional and neuraxial techniques

Intraoperative management

Monitoring and access

Induction and airway management

Positioning

  • Lithotomy

Maintenance and surgical considerations

  • Stimulation of the obturator nerve during resectoscope passage into the urethra can cause a significant reflect, even while under GA. To avoid this reflex, muscle relaxation is often used. However, studies[1] have shown that TIVA with LMA is a safe, reliable, and controllable method for maintenance of anesthesia with blunting of the obturator reflex.

Emergence

Postoperative management

Disposition

  • PACU

Pain management

Potential complications

  • Bladder perforation (most serious complication)
  • Urethral rupture or false passage
  • Bleeding
  • Reabsorption

Procedure variants

Variant 1 Variant 2
Unique considerations
Position
Surgical time
EBL
Postoperative disposition
Pain management
Potential complications

References

  1. "Total intravenous general anesthesia with laryngeal mask airway for transurethral resection of bladder tumor". Journal of Medical Colleges of PLA. 22 (4): 234–237. 2007-08-01. doi:10.1016/S1000-1948(07)60047-1. ISSN 1000-1948.