Bladder Polyp Removal (TURBT): Postoperative Care & Recovery Guide

Transurethral resection of bladder tumor (TURBT) for polyp removal requires careful postoperative management to prevent complications and ensure complete healing.

Immediate Postoperative (First 24–48 Hours)

• Continuous Bladder Irrigation (CBI): Often used initially to prevent clot retention; monitored for color/flow.
• Foley Catheter: Typically remains 1–3 days (longer if large resection, perforation risk).
• Hydration: IV fluids + oral target 2–3 L/day once tolerated; flushes debris, reduces clot risk.
• Pain Control: Usually mild; oral analgesics (acetaminophen, NSAIDs if no contraindication). Opioids rarely needed.
• Activity: Bedrest while CBI running; ambulate after catheter removal.

After Catheter Removal (Days 1–3 Post-TURBT)

• Voiding Trial: Must void adequately (>150–200 mL) with acceptable PVR (<100–150 mL).
• Expected Symptoms: Dysuria, urgency, frequency, hematuria (pink urine) — improve over 1–2 weeks.
• Clot Passage: Small clots normal; large clots or inability to void → contact urologist / ER.

Activity & Diet Restrictions (2–4 Weeks)

• No heavy lifting (>10–15 lbs), straining, vigorous exercise.
• Avoid constipation (fiber, stool softener) — straining increases bladder pressure.
• Limit bladder irritants: caffeine, alcohol, carbonated drinks, spicy foods, acidic juices, artificial sweeteners.
• No sexual activity until cleared (typically 2–4 weeks).

Medications

• Antibiotics: often 1–3 days perioperative; longer if indicated.
• Anticholinergics/beta-3 agonists (oxybutynin, mirabegron) for urgency if bothersome.
• Phenazopyridine (Pyridium) for dysuria — short-term only (orange urine).

Follow-Up & Surveillance

• Cystoscopy at 3 months: First surveillance; critical for detecting recurrence.
• Pathology review: determines risk category (low/intermediate/high) per EAU/AUA guidelines → sets surveillance schedule.
• Intravesical therapy (BCG, mitomycin) may be recommended for intermediate/high risk.

Red Flags – Call Urologist Immediately

• Inability to urinate, large clots, heavy bleeding
• Fever >100.4°F, chills, flank pain (possible perforation/sepsis)
• Worsening dysuria not improving after 1 week

Adherence to follow-up cystoscopy is the single most important factor in long-term bladder cancer control.