Fulguration is an electrosurgery. It uses heat from an electrical current to destroy atypical tissue areas. Healthcare professionals often use it to treat early stage bladder cancer, but they can use it to treat other bladder conditions as well.

Various conditions can affect the bladder. One of these is bladder cancer, and 82,290 new bladder cancer diagnoses may occur in the United States in 2023.

If you’ve received a bladder cancer diagnosis, part of your treatment may include fulguration. Fulguration uses heat derived from an electrical current to destroy atypical tissue.

Healthcare professionals may also use fulguration to treat other bladder conditions. Keep reading to discover what to expect during this procedure and more.

Fulguration involves using heat from a high energy electrical current to destroy an atypical tissue area, such as a cancer lesion. It’s a type of electrosurgery.

Doctors perform bladder fulguration in a transurethral manner. This means they pass the devices used in the procedure into your bladder through your urethra, the small tube through which urine leaves your body when you pee. You don’t need to have an incision (cut).

Healthcare professionals often use fulguration as a part of bladder cancer treatment in a procedure called transurethral resection of bladder tumor (TURBT). After they remove the cancer, they use fulguration to help destroy the remaining cancer cells.

They use TURBT for non-muscle invasive bladder cancers, which include stage 0 and some stage 1 bladder cancers. Doctors can diagnose about 50% of bladder cancers while the cancers are still in these stages.

Doctors may also use fulguration for small, less aggressive bladder cancers that have come back (recurred).

They can use fulguration to treat several other bladder conditions as well, such as:

Healthcare professionals perform fulguration once they give you an anesthetic that can put your body under anesthesia, a period during the procedure when you fall asleep or lose sensation in an area of your body. This can prevent you from feeling pain during the procedure.

Depending on your situation, they may provide one of several anesthetic types:

  • General anesthetic: A general anesthetic can put you to sleep during the procedure.
  • Spinal anesthetic: When you have a spinal anesthetic, you remain awake but have numbness from the waist down.
  • Local anesthetic: A local anesthetic numbs your bladder and urethra.

Your doctor can then pass a resectoscope device through your urethra and into your bladder. The resectoscope has a light and magnifying glass on the end that allows your doctor to see inside your bladder.

A wire loop on the resectoscope can carry an electrical current. Your doctor can use this for fulguration, utilizing the heat from this current to destroy atypical tissue.

Your doctor can do tests to assess your overall health and make sure you’re well enough to have your procedure. This testing may also help your doctor identify factors that may increase your risk of complications during or after your procedure.

The exact tests that doctors may perform can vary, but they generally include:

Your doctor can also give you specific instructions on how to prepare. Be sure to follow them carefully. For example, your doctor may:

  • tell you when to stop eating or drinking before your procedure
  • give you information on whether you need to adjust or stop taking certain medications or supplements beforehand
  • inform you of when you need to stop smoking before your procedure

Fulguration of the bladder can be an outpatient procedure. That means that you can return home shortly after it’s over. However, depending on the exact procedure, you may need to stay in the hospital overnight.

Your doctor can instruct you on when you can return to your typical daily activities. This may vary by the type and extent of the procedure you have.

For example, the American Cancer Society notes that many people who’ve had TURBT can return to their usual activities in a week or two.

Like any medical procedure, having fulguration of your bladder comes with the risk of complications. These may include:

Before your procedure, your doctor can review its various risks with you. During this time, be sure to raise any questions or concerns.

Bladder cancer

Experts note in a summary of bladder cancer treatment options that TURBT with fulguration followed by intravesical therapy can reduce the recurrence rate of early stage bladder cancer.

However, they also note that many bladder cancers treated this way can often return. This can make regular monitoring after fulguration for bladder cancer vital.

Bladder diverticula

A 2016 case report showed that some healthcare professionals can use fulguration to treat bladder diverticula effectively. Also, a small study from 2018 found that larger bladder diverticula could be effectively treatable with fulguration or minimally invasive laparoscopic surgery.

Interstitial cystitis

According to a 2020 research review, fulguration can effectively treat lesions associated with interstitial cystitis. However, it noted that repeat treatments may often be necessary.

In a small study from 2022 involving people with interstitial cystitis, experts found that adding hydrodistension, a process through which a healthcare professional fills the bladder with water, to fulguration helped manage pain and improve treatment effectiveness.

Recurrent UTIs

Researchers performed a small 2019 study of fulguration in women with recurrent UTIs who didn’t respond to antibiotics. They found the procedure was effective in 65% of participants. Of these, more than 80% had long-term improvement in UTIs or their conditions cured.

A small 2022 study found comparable results, with 63% of participants having a complete resolution of their UTIs. The researchers noted that, despite this, most of the study participants still had a decrease in their UTI frequency.

What are the side effects of bladder fulguration?

It’s common to have a small amount of blood in your urine after fulguration. You may also feel an increased need to urinate. You might also experience pain and discomfort around your bladder, including when you urinate.

These side effects generally go away in a few days. Your doctor can prescribe medications that may help manage pain and discomfort when urinating.

What’s the difference between fulguration and cryoablation?

Fulguration uses the heat generated by an electrical current to destroy atypical tissue. In contrast, cryoablation uses extreme cold to destroy that type of tissue.

What is a cystoscopy biopsy and fulguration of the bladder?

A cystoscopy biopsy and fulguration of the bladder are essentially the same as a TURBT. Doctors can perform it during the diagnostic process for bladder cancer.

A doctor passes a device called a cystoscope through your urethra and into your bladder, allowing them to look for signs of cancer. If they find an atypical area, they can perform a biopsy. Then, they can treat the area with fulguration.

Fulguration of the bladder involves using the heat from an electrical current to destroy atypical tissue areas. Doctors may use it to help treat early stage bladder cancer and several other bladder conditions.

The exact experience and outcome that you have can depend on the condition doctors use fulguration to treat. Your doctor can give you a better idea of how to prepare, what to expect, and any side effects or complications to know.