What is a bladder biopsy?

A bladder biopsy is a diagnostic surgical procedure in which a doctor removes cells or tissue from your bladder to be tested in a laboratory. This typically involves inserting a tube with a camera and a needle into the urethra, which is the opening in your body through which urine is expelled.

Your doctor will likely recommend a bladder biopsy if they suspect your symptoms might be caused by bladder cancer. The symptoms of bladder cancer include:

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

These symptoms can be caused by other things, such as an infection. A biopsy is done if your doctor strongly suspects cancer or finds cancer through other, less invasive, tests. You’ll have tests of your urine and some imaging tests, such as an X-ray or CT scan, before the procedure. These tests will help your doctor determine if there are cancer cells in your urine or a growth on your bladder. The scans cannot tell if the growth is cancerous. That can only be determined when your biopsy sample is reviewed in a laboratory.

All medical procedures that involve removing tissue put you at risk for 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. Drinking plenty of fluids will help flush these out.

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

Before your biopsy, your doctor will take your medical history and do a physical examination. During this time, inform your doctor of any medicines you’re taking, including OTC drugs, prescription medications, and supplements.

Your doctor may instruct you to avoid liquids for a certain amount 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 ask you to urinate before the procedure.

The procedure typically lasts about 15 to 30 minutes. You can have the biopsy in your doctor’s office or a hospital.

First, you’ll be seated in a special chair that puts you in a reclined position. Your doctor will clean and numb your urethra 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’s inserted into your urethra. In men, the urethra is at the tip of the penis. In women, it’s located just above the vaginal opening.

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

Once your doctor inflates your bladder with water or a saline solution, they 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 have a slight amount of pain when the tool is removed.

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 in the biopsy sample. If you have bladder cancer, the biopsy helps determine two things:

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

Low-grade cancer is easier to treat than high-grade cancer, which occurs when the cells have reached the point where they no longer look like normal cells.

The number of cancer cells and the extent of their presence in your body will help determine the stage of cancer. You may need other tests to help your doctor confirm the biopsy’s finding.

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

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

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

Call your doctor if you have blood in your urine after three days. You should also call your doctor if you have:

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

You shouldn’t have sex for two weeks after your biopsy. Drink plenty of fluids, and avoid heavy lifting and strenuous activity for 24 hours after the procedure.