Transurethral Bladder Biopsy

Front view cross section of bladder showing cystoscope inserted through urethra to bladder.

Transurethral bladder biopsy is done to help find the cause of a bladder problem, such as bladder cancer. During the procedure, small tissue samples are taken from the inside of your bladder. The samples are then tested in a lab. This sheet explains how the procedure is done.

Preparing for the procedure

Prepare as you have been told. In addition:

  • Tell your healthcare provider about all medicines you take. This includes herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may need to stop taking some or all of them before surgery. Your healthcare provider may tell you to stop aspirin several days before the procedure.

  • Your healthcare providers may tell you not to eat or drink during the hours before your procedure. (If you have been instructed to take medicines, take them with a small sip of water.)

The day of the procedure

The procedure takes about 30 to 45 minutes. You’ll likely go home the same day.

Before the procedure begins

What to expect before the procedure:

  • An IV line is put into a vein in your arm or hand. This line supplies fluids and medicines (such as antibiotics).

  • To keep you free of pain during the procedure, you might be given general anesthesia. This medicine puts you into a state like deep sleep. Or you may be given spinal anesthesia. This medicine numbs only your body from the waist down. In some cases, local anesthesia is used. This medicine numbs only the area being treated.

During the procedure

What to expect during the procedure:

  • A special tool called a cystoscope (scope) is used. The scope is a thin, lighted tube with a tiny lens on the end to see inside the bladder. The healthcare provider inserts this through the urethra into the bladder.

  • Water is sent through the scope to fill the bladder. This stretches the bladder to give the healthcare provider a better view.

  • A small surgical tool is passed through the scope into the bladder. Samples of tissue are then removed from the bladder. An electric tool may be used to stop any bleeding.

  • When the procedure is complete, all tools are removed and the bladder is drained.

  • A thin tube (Foley catheter) may be placed in your bladder to drain urine while the bladder heals.

After the procedure

You’ll be taken to a room to rest until the anesthesia wears off. If a breathing tube was used, your throat might be sore at first. You might be given medicines to manage pain and prevent infection. After a few hours, you’ll be released to go home. Have an adult family member or friend ready to drive you.

Recovering at home

Once you’re home, be as active as you comfortably can. Get up and walk around, but avoid exercise or heavy activities until you feel better. You can likely return to your normal routine in 1 to 2 days. If you go home with a catheter, care for it as directed. And follow any special instructions your healthcare provider gave you.

Call the healthcare provider

Contact your healthcare provider if you have any of the following:

  • Chest pain or trouble breathing (call 911 or other emergency service) 

  • A fever of 100.4°F (38°C) or higher 

  • Pain that’s not controlled with medicine

  • Trouble urinating or inability to urinate

  • Bloody urine for more than 48 hours

Follow-up

You’ll have a follow-up visit with your healthcare provider in about 7 days. During this visit, your healthcare provider will discuss the results of your biopsy. You and your healthcare provider will also discuss any treatments that might be needed.

Risks and possible complications 

These include:

  • Pain or burning when urinating for a day or so after the procedure

  • Bleeding or blood in the urine

  • Infection

  • Damage to the bladder wall (may require temporary catheter drainage or further repair)

  • Narrowing of the urethra

  • Risks of anesthesia (the anesthesiologist will discuss these with you)



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