Transurethral Resection of Bladder Tumour (TURBT) is a minimally invasive removal of bladder tumours. This procedure is both diagnostic and therapeutic. It allows for examination of the tumour under a microscope and also allows for the complete removal of all visible tumours. In some cases, a second TURBT is required after several weeks to ensure that the cancer has been completely removed and that the initial staging was accurate. TURBT can eradicate non-muscle invasive bladder cancer.

​TURBT can eradicate non-muscle invasive bladder cancer. However, there is a still a possibility of recurrence (cancer returning) within the bladder. The chance of recurrence can be reduced by instilling medications within the bladder several weeks after completion of TURBT. 

This medication is called Bacillus-Calmette Guerin (BCG), a live but weakened bacteria, similar to the BCG used in Singapore's national vaccination programme against tuberculosis. The BCG bacteria is placed as a solution into the bladder through a urinary catheter. This BCG causes inflammation of the bladder wall which in turn stimulates the immune system to kill any cancer cells which may be present in the bladder. 

The drug itself stays in your bladder for two hours and is then drained out through the urinary catheter, or leaves your bladder when you pass urine. The recommended number of sessions of BCG instillation depends on the aggressiveness of the original bladder cancer but most patients would receive at least 6 weekly sessions and a booster of 3 weekly sessions 3 months later. Your urologist will advise you accordingly.

​The mainstay of treatment to cure muscle-invasive bladder cancer is the surgical removal of the urinary bladder. The urinary bladder is removed through open surgery. A segment of small intestine is used to create a conduit (pouch) to collect urine from the kidneys. This pouch drains urine out of the body through an opening created in the abdominal wall called a stoma. In selected cases, the small intestine can be used to create a new urinary bladder (neobladder) which allows patients to urinate through the urethra.

​Radiation therapy is an option for preserving the bladder in patients who are not candidates for surgery or who do not want surgery. Results from radiotherapy alone are worse than those from complete removal of the bladder, but if combined with chemotherapy (chemoradiation), acceptable results can be achieved. Side effects include mild to strong irritation of the bladder and digestive tract as well as blood in the urine or stools, incontinence, increased risk of infections, and fistulas (abnormal passages that develop between organs).

​After any kind of cancer treatment follow-up is essential. If the bladder has not been removed, regular cystoscopy is recommended to detect any recurrence of cancer early. Regular scans will also be arranged to ensure that cancer does not return in other organs, lymph nodes or in the kidneys and ureters.