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TURB-Bladder - Medium Biopsy 1-3 cm

Biopsy
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No Fasting Required

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Biopsy from bladder tumor.

₹370₹529

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TURB-Bladder - Medium Biopsy 1-3 cm

  • Why is it done?
    • Test Purpose: TURB-Bladder (Transurethral Resection of Bladder) with medium biopsy (1-3 cm) is a diagnostic and therapeutic endoscopic procedure used to obtain tissue samples from bladder lesions, tumors, or suspicious areas for histopathological examination
    • Detects: Bladder cancer (urothelial carcinoma), benign prostatic hyperplasia involvement, chronic inflammation, polyps, strictures, and other bladder abnormalities identified via cystoscopy
    • Primary Indications: Hematuria (blood in urine), suspected bladder malignancy, visible lesions on imaging or cystoscopy, follow-up of known bladder cancer, recurrent urinary tract infections with atypical findings
    • Timing: Performed when cystoscopy reveals suspicious lesions or abnormalities; typically urgent if malignancy is suspected; routine follow-up for patients with history of bladder cancer
  • Normal Range
    • Normal/Negative Result: Benign urothelium (normal bladder lining cells) without evidence of malignancy, atypia, or significant inflammation
    • Specimen Size: 1-3 cm tissue samples adequate for histopathological diagnosis and staging
    • Units of Measurement: Tissue sample dimensions measured in centimeters; histology reported using WHO classification for bladder neoplasms
    • Abnormal Findings: Presence of neoplastic cells (tumorous growth), malignant transformation, atypia, dysplasia, carcinoma in situ (CIS), or evidence of non-muscle invasive or muscle-invasive disease
    • Interpretation Key: Negative = no malignancy; Positive = malignancy confirmed; Atypical = suspicious findings requiring further investigation or repeat biopsy
  • Interpretation
    • Benign Findings: Normal urothelium, cystitis (inflammation), benign polyps, or reactive changes indicate absence of malignancy; further follow-up based on clinical context
    • Non-Muscle Invasive Bladder Cancer (NMIBC): Stage Ta (limited to mucosa), T1 (lamina propria involvement), or Tis (carcinoma in situ); carries risk of recurrence (50-70%) and progression; requires intravesical therapy and regular surveillance
    • Muscle-Invasive Bladder Cancer (MIBC): Stage T2 or higher (invasion into muscularis propria or beyond); indicates aggressive disease requiring radical cystectomy, chemotherapy, or radiation therapy
    • Grading System: Low-grade tumors (Grade 1-2) have better prognosis; high-grade tumors (Grade 3) indicate poor differentiation and higher risk of progression and mortality
    • Factors Affecting Results: Specimen adequacy, biopsy site location, presence of muscle in sample (crucial for staging), prior radiation or chemotherapy, concurrent urinary tract infection, immunosuppression status
    • Clinical Significance: Results directly influence treatment decisions, staging accuracy, prognosis estimation, and surveillance intervals; inadequate muscle in specimen may require repeat TURB
  • Associated Organs
    • Primary Organ System: Urinary bladder (urothelium); lower urinary tract and urinary system
    • Related Structures: Urethra, prostate (in males), ureters, regional lymph nodes, peritoneum (if perforation occurs)
    • Diseases Detected: Urothelial carcinoma (90% of bladder cancers), squamous cell carcinoma, adenocarcinoma, small cell carcinoma, bladder adenitis, tuberculosis of bladder, schistosomiasis-related changes, radiation cystitis
    • Conditions Associated with Abnormal Results: Smoking history, chronic irritation, bladder outlet obstruction, chronic catheterization, chemical exposure, pelvic radiation, schistosomiasis haematobium, Balkan nephropathy, hereditary cancer syndromes (BRCA mutations)
    • Potential Complications of Abnormal Findings: Local invasion of adjacent tissues (prostate, rectum, peritoneum), metastatic spread (bones, lungs, liver, brain), obstructive uropathy from tumor growth, sepsis from infected necrotic tissue, hemorrhage, bladder perforation, systemic complications from advanced malignancy
    • Procedural Complications: Hematuria, bladder perforation, urinary retention, urinary tract infection, sepsis, electrolyte imbalance (TURP syndrome if irrigation fluid absorbed), urethral stricture
  • Follow-up Tests
    • If Malignancy Confirmed: Staging imaging (CT abdomen/pelvis, MRI, bone scan, PET-CT depending on stage), upper urinary tract imaging (IVP, CT urography), chest X-ray or chest CT for pulmonary metastases screening
    • Urinalysis and Urine Cytology: Serial urine cytology for high-grade tumors or CIS to detect recurrence; baseline and periodic urinalysis for surveillance
    • Cystoscopy Surveillance: For NMIBC: every 3 months for first 2 years, then every 6 months to 1 year; flexible cystoscopy with or without narrow-band imaging; repeat TURB at 4-6 weeks for high-grade Ta, T1, or CIS if no muscle present in initial biopsy
    • Immunotherapy Assessment: Immunophenotyping for CIS; PD-L1 expression testing for treatment planning; molecular profiling (FGFR3, ERCC2 mutations) for advanced disease management
    • Intravesical Therapy Monitoring: If BCG or chemotherapy administered: response assessment at 3-6 months with repeat cystoscopy and biopsy if indicated; tolerability monitoring
    • Laboratory Tests: Complete blood count, renal function (creatinine, BUN), liver function tests, uric acid (for tumor lysis syndrome risk), prostate-specific antigen (if prostate involvement suspected)
    • Post-Procedure Monitoring: Observation for hematuria, dysuria, and urine retention within 24 hours; renal ultrasound if bladder perforation suspected; post-void residual measurement if retention occurs
  • Fasting Required?
    • Fasting Requirement: YES
    • Duration: 6-8 hours fasting period (typically NPO after midnight if morning procedure); some centers require only 4-6 hours if using local anesthesia; confirm with facility
    • Fluid Intake: NPO (nothing by mouth) including clear fluids if general or spinal anesthesia planned; may consume water up to 2 hours before if local anesthesia only
    • Medications: Continue routine cardiac and antihypertensive medications with minimal sips of water; hold anticoagulants (warfarin, direct oral anticoagulants) 3-5 days before procedure; discontinue antiplatelet agents (aspirin, clopidogrel, NSAIDs) 5-7 days prior unless high thrombotic risk; metformin should be discontinued if contrast imaging planned
    • Pre-Procedure Laboratory: Complete blood count, comprehensive metabolic panel, coagulation studies (PT/INR, PTT) if on anticoagulation; urinalysis and urine culture to rule out infection
    • Patient Preparation: Urinate before procedure; remove dentures, hearing aids, prosthetics, makeup; empty bladder; obtain informed consent; arrange transportation if sedation used; wear hospital gown; void immediately before transfer to operating room
    • Special Instructions: Showering morning of procedure is acceptable; avoid heavy meals; bring list of all medications and allergies; report any active infections or fever; if diabetic, consult physician about glucose management on procedure day; instruct patient on post-operative care and activity restrictions

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