There is some risk for urinary tract infection (UTI). There is a slight risk for excessive bleeding. There may be a rupture of the bladder wall with the cystoscope or during biopsy. There is also a risk that the biopsy will fail to detect a serious condition.
In this series, urothelial cancer was detected by random bladder biopsies in 15.8% of the included patients. Of the 100 patients who were diagnosed as low risk NMIBC, including low grade, small size and solitary tumors, concomitant urothelial cancer was detected in 10 (10%) patients by the random biopsies.
You should expect to return to work in 1 week or less. You should reduce your activity levels for the first 1 to 2 weeks while healing. Use stairs gently for the first week. No heavy lifting, pulling or pushing over 10 to 15 pounds for 2-3 weeks.
Risks of undergoing a bladder biopsy
You might get a UTI, or a urinary tract infection. You might also develop a blockage in your urethra, or experience excessive pain while urinating. In extreme cases, you might rupture your bladder during the procedure, or bleed more than expected.
The test will take about 30 minutes.
Cystoscopy with bladder biopsies is generally performed as an outpatient procedure with the patient under general anesthesia. On occasion, it can be performed in the urologist's office, with local anesthesia obtained by instilling anesthetic agents into the bladder.
You will feel discomfort that is similar to a strong urge to urinate when the fluid has filled your bladder. You may feel a pinch during the biopsy. There may be a burning sensation when the blood vessels are sealed to stop bleeding (cauterized). After the cystoscope is removed, your urethra may be sore.
You may feel a burning sensation during urination for a day or two. There may be blood in the urine. In most cases, this will go away on its own. In some cases, the biopsy needs to be taken from a large area.
Removing part of the bladder is not a common operation for bladder cancer. It is usually a treatment for a very rare type of cancer called adenocarcinoma of the bladder. After having a partial cystectomy, you can pass urine in the normal way.
You can return to your normal activities – including work, exercise and having sex – as soon as you feel able to after a flexible cystoscopy. This will often be later the same day or possibly the day after.
You may still have the urinary catheter in your bladder. It may be removed before you're discharged or a few days after your procedure. If your catheter is removed before you go home, you must urinate before you're discharged.
Some bladder tumors are benign (noncancerous), while others are malignant (cancerous). Malignant bladder tumors – also known as bladder cancer – can spread (metastasize) into other parts of the body.
The general 5-year survival rate for people with bladder cancer (i.e., the percentage of patients who would be expected to survive the effects of their bladder cancer for 5 years or more) is 77%, while the 10-year survival rate is 70% and the 15-year survival rate is 65%1.
Your doctor may ask you not to do certain activities for a while based on where you had the biopsy and whether it was open or closed. Unless your doctor tells you otherwise, you can do your normal activities when you feel ready. Be active. Walking is a good choice.
Transurethral bladder tumor resection (TURBT).
During TURBT, a surgeon inserts a cystoscope through the urethra into the bladder. The surgeon then removes the tumor using a tool with a small wire loop, a laser, or high-energy electricity, which is called fulguration.
A cystoscopy can reveal abnormal cells
A biopsy involves taking a very small sample of tissue from the bladder to be analyzed in the laboratory. The TURBT procedure can be used to take the biopsy that is needed to make a definite diagnosis of bladder cancer.
Surgical (excisional) biopsy.
This type of biopsy is done using surgery to remove the tissue your doctor thinks may be cancer. The surgeon makes an incision (cut) into the skin to remove the suspicious tissue. The complexity of the surgery depends on the area of the body involved.
You can usually eat and drink as normal before a flexible cystoscopy. Before the procedure starts, you'll be asked to undress from the waist down and put on a hospital gown. You may be asked to pee into a container so it can be checked for an infection. The procedure may be delayed if a urine infection is found.
Drink at least 8 (8-ounce) cups of fluids, such as water, every day for the next few days. The liquids will help flush your bladder. This is important to help lower the amount of bleeding you may have.
A biopsy is essential in diagnosing bladder cancer and occurs when a sample of abnormal-appearing bladder tissue is removed and examined under a microscope for cancer cells.
Most biopsies will only require local anaesthetic, which means you won't need to stay in hospital overnight. However, an overnight stay is sometimes required when the biopsy is carried out under general anaesthetic. After having a biopsy, you won't usually feel any pain.