Bladder Biopsy

Written by Brian Krans | Published on August 15, 2012
Medically Reviewed by George Krucik, MD

What is a Bladder Biopsy?

A bladder biopsy is a surgical procedure where cells or tissue from your bladder are removed to be tested in a laboratory. Typically, this is done is by inserting a needle into your urethra—the opening in your body from which urine is expelled.

Why a Bladder Biopsy Is Done

Your doctor will perform a bladder biopsy if he or she suspects your symptoms might be caused by bladder cancer. Symptoms of bladder cancer include:

  • blood in the urine
  • frequent urination
  • painful urination
  • lower back pain

Prior to the procedure, you’ll undergo some imaging tests, such as an X-ray or CT scan. These will help your doctor determine if there is a growth on your bladder. The scans, however, cannot tell if the growth is cancerous. That can only be determined when your biopsy sample is reviewed in a laboratory.

The Risks of a Bladder Biopsy

All medical procedures that involve removing tissue run the risk of bleeding and infection. A bladder biopsy is no different.

After your bladder biopsy, you may have blood or blood clots in your urine. This typically lasts for two or three days following the procedure, but drinking plenty of fluids can help clear these.

You may also experience a burning sensation when you urinate. This is best treated with over-the-counter pain relief medicines. Your doctor may prescribe stronger painkillers if you need them.

How to Prepare for a Bladder Biopsy

Before your biopsy, your doctor will perform a complete medical history and physical examination. During this time, inform your doctor of any medicines you are taking, including over-the-counter drugs, prescription, and supplements.

Your doctor may instruct you to avoid liquids for a certain period of time before your procedure. Be sure to follow these instructions and any others your doctor gives you.

When you arrive for your biopsy, you’ll change into a hospital gown. Your doctor will also have you urinate before the procedure.

How a Bladder Biopsy Is Performed

The procedure typically lasts less than 20 minutes. You can have the biopsy in your doctor’s office or in a hospital.

First, you will be seated in a special chair that puts you in a reclined position. Your urethra is then cleaned and numbed using a topical painkiller, or a numbing cream.

During the procedure, your doctor will use a cystoscope. This is a small tube with a camera that is inserted into your urethra. In men, the urethra is at the tip of the penis. In women, it is located just above the vaginal opening.

Water or a saline solution will flow through the cystoscope to fill the bladder. You may feel the need to urinate. This is normal. Your doctor will ask you about the feelings you are experiencing. This helps determine the cause of your symptoms.

Once the bladder is inflated with water or a saline solution, your doctor can inspect the bladder wall. During this inspection, your doctor will use a special tool on the cystoscope to remove a small part of the bladder wall to be tested. This may cause a slight pinching feeling.

You may also experience a slight amount of pain when the tool is removed.

Following Up After a Bladder Biopsy

It usually takes a few days for the results to be ready. Afterward, your doctor will want to discuss your test results with you.

Your doctor will be looking for cancer cells inside the biopsy. If you have bladder cancer, the biopsy helps determine two things:

  • invasiveness, or how deeply the cancer has progressed into the bladder wall
  • grade, or how closely the cancer cells look like bladder cells

If the cancer cells still closely resemble your bladder cells, then your case is low-grade. Low-grade cancers are easier to treat than high-grade cancers, or cancers that have reached the point where the cells no longer look like normal cells.

The number of cancer cells and the extent of its presence in your body will help determine the stage of cancer. Other testing may be needed to help confirm the biopsy’s finding.

When your doctor knows the grade and invasiveness of your cancer, he or she can better plan for your treatment.

Remember, not all abnormalities in the bladder are cancerous. If your biopsy does not show cancer, it can help determine if another complication is causing your symptoms, such as:

  • infection
  • cysts
  • ulcers
  • bladder diverticulum, or balloon-like growths on the bladder

If you experience blood in your urine after three days, call your doctor. According to the University of Wisconsin-Madison, you should also call your doctor if you experience:

  • burning sensation when you urinate after the second day
  • cloudy urine
  • foul-smelling urine
  • large blood clots in the urine
  • new pains in your lower back or hip

After your biopsy, you shouldn ’t have sex for two weeks. Remember to drink plenty of fluids, and avoid heavy lifting and strenuous activity for 24 hours.

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