Fulguration of the Bladder: What You Should Know

Written by Rachel Reiff Ellis
Medically Reviewed by Nazia Q Bandukwala, DO on May 04, 2025
8 min read

Instead of cutting, bladder fulguration kills and breaks up abnormal cells with an electric spark. Fulguration can stop bleeding, too. This type of electrosurgery commonly treats bladder cancer and other bladder problems.

The word fulgur comes from Latin and means lightning. Just like a lightning strike, your urologist (bladder and kidney specialist) uses a metal probe to make the tiny spark. 

The probe doesn't touch your skin. But the air between the probe and your skin gets charged with about 100,000 volts. That's about half the starting voltage for a taser gun. 

With fulguration, the electricity flows into your skin to seal arteries or kill cells. The heat destroys a few layers of skin, but it doesn't go deeper. Fulguration can protect your organs and deeper skin layers. Then, the current returns to the device (the electrosurgical generator).

Does insurance cover fulguration of the bladder?

Typically your health insurance covers fulguration as part of your surgery. But it can depend on your insurance coverage. 

“A bladder fulguration is usually medically necessary," says Nathaniel N. Johnson, MD, a urologist at MaineHealth in Biddeford, Maine. "[This] means your doctor has to do it to diagnose or treat your problem.” 

Why you’re getting fulguration can also matter. “Your doctor will have to provide the proper documentation to your health insurance company for your coverage," says Johnson. "You may need to get pre-authorization."

A pre-authorization, also called a prior authorization, may not guarantee coverage. But it can make coverage more likely. Prior authorizations are very common before surgery. Your doctor's office usually gets this approval.

"[The prior authorization] process [is] where your health insurance company reviews your proposed course of treatment before you get it,” says Johnson.

You can call your health insurance company and doctor to ask what's needed.

Fulguration treats many bladder conditions. Electrosurgery can destroy benign (noncancerous), precancerous, or cancerous cells.

You might need a bladder fulguration because you have:

Bladder cancer. Urologists can diagnose and treat non-muscle invasive bladder cancer. They use the transurethral resection of bladder tumor (TURBT) procedure. This surgery can remove your cancer cells using fulguration. 

Your doctor uses a probe with a tiny metal loop called a resectoscope. The loop releases electricity for fulguration to kill cancer cells or stop bleeding.

Interstitial cystitis. This condition irritates and inflames the walls of your bladder. With infection, radiation, or chemotherapy, bleeding (hemorrhagic cystitis) can also happen. You may bleed, have pain, or pee more often — even with a small amount of pee in your bladder. 

You can also get ulcers in your bladder (Hunner ulcers). About 5% to 10% of people with interstitial cystitis have Hunner ulcers. Fulguration can help your symptoms, stop bleeding, and remove ulcers. That's because fulguration can get rid of the tissue causing your symptoms.

Bladder polyps. Sometimes a small mass in your bladder is not cancer (noncancerous). This little clump of cells is called a polyp. Polyps can cause pain and the need to pee more often. Your doctor can get rid of the polyps using fulguration during your TURBT procedure.

Bleeding after a procedure. Fulguration causes loss of water (dehydration) in your tissues. Electrosurgery isn't ideal to stop bleeding in most cases. That's because it can damage tissues and raise complications. 

But electrosurgery is useful for vascular (more blood vessels) organs like the bladder. And if you have a large area that's bleeding, fulguration can help, too.

Recurrent UTIs. In some cases, bladder fulguration can treat chronic urinary tract infections (UTIs). If you've gone through menopause and antibiotics aren't working, fulguration can lower your UTI risk. Electrosurgery may also improve your quality of life.

Bladder diverticula. These are pouches in your bladder wall called diverticula. The pouches can cause discomfort and problems emptying your bladder. You may also feel like going to the bathroom more often. Some doctors can remove the pouches using fulguration.

Depending on your medical condition, fulguration can work better to treat small tumors. Electrosurgery is minimally invasive — it doesn't require any large cuts.

Before the procedure

Your doctor will give you instructions to prepare for bladder fulguration. You can ask about what to expect:

  • Should I stop eating and drinking at a certain time before my procedure?
  • Should I stop taking any of my regular medications before my surgery?
  • Will I be going home the same day you do the procedure, or will I need to stay in the hospital?
  • What kind of anesthesia will I get for my procedure?
  • Do I need someone to drive me home?

During the procedure

You may get bladder fulguration using a local anesthesia. It's a shot to numb the area before fulguration. But if you're having surgery, you'll get general anesthesia. That means you'll be asleep and unaware of what’s going on. 

Your doctor first puts a cystoscope into your urethra. Your urethra (the tube allowing urine to leave your body) connects to your bladder. The cystoscope is a long, thin tube with a light and camera on it. This helps your urologist see inside your bladder as they work. 

If you have local anesthesia, you may feel slight pressure. But you won't feel anything if you're asleep. Next, your urologist removes any abnormal tissue. They'll use the wire loop on a resectoscope. 

The probe emits a high-intensity electrical current, too. An electrosurgical generator creates the high-frequency, short-wave currents. Your urologist can adjust this electricity (electrical current) to burn specific areas inside your bladder. Using the probe, they’ll make a tiny spark. 

This fulguration breaks down any growths and can help stop bleeding. You might feel a pinching sensation or a little discomfort if you're awake.

How long does it take?

For biopsies and destroying small areas, fulguration takes about five minutes. If you’re having fulguration with a TURBT procedure, it can take 15 to 90 minutes. But it can depend on how large your tumors are and how many you have, too.

Your recovery can depend on factors like your surgery, anesthesia, or why you're getting bladder fulguration. 

Fulguration of the bladder side effects

With bladder fulguration, you may get side effects like: 

Bleeding near your cut. Apply pressure and the bleeding should stop after 20 minutes.

Blood in your pee (hematuria). Your pee can come out pink or red. Hematuria should go away after a few days.

Urinary tract infection (UTI). The signs of a UTI include fever, burning when you pee, and cloudy or foul-smelling pee.

Pain or burning when you pee (dysuria). You may feel this around your bladder. Dysuria is usually mild and goes away within a few days. Your doctor can prescribe medications to help bring relief.

Urgent need to pee. You may need to pee more often or quickly. This happens because your bladder is irritated but should go away. ​

Trouble emptying your bladder. You may not feel like you can empty your bladder all the way. This is called urinary retention.

Bladder spasms. You may feel pain when this happens. You may also feel like you need to pee.

How long does fulguration recovery take?

You can have bladder fulguration as an outpatient in your doctor’s office. You'll go home shortly after fulguration. Or you may need to have electrosurgery in a hospital and stay overnight or longer, depending on your surgery. 

The actual area that gets the fulguration heals like a typical burn, says Johnson. “You can think of it like any other mild burn you might get. The burn scabs over, the scab comes off, and the tissue returns to normal." 

For larger fulgurations, like a TURBT surgery, complete recovery can take 5-7 days. "It takes longer to heal inside your body than outside your body," says Jaohnson. "The environment is wet, exposed to your changing urine pH, and not exposed to air.”

During this time, try to rest. Avoid hard activities or exercise. This time of rest allows your bladder to heal. And giving yourself healing time can lower your risk for bleeding. Recovery is different for each person. Yours may be longer or shorter. Be patient and listen to your body.

Ask your doctor:

  • How long should I expect my healing to take?
  • What medications will I need to take for pain?
  • When should I follow up with you after surgery?

When to call your doctor

You may have an infection or need follow-up care after your procedure.  

Get medical help right away if you have: 

  • Fever above 101°F 
  • Heavy bleeding or bleeding that won't stop
  • Serious belly (abdominal) pain

Like any medical procedure, bladder fulguration has some risks. Your urologist is trained to keep risks low. Serious side effects are rare but possible. 

With bladder fulguration, you may have:

Reaction to anesthesia. Anesthesia can cause nausea, vomiting, or confusion. If you have an unknown anesthesia allergy, it can be serious.

Tissue damage during the procedure. Fulguration or other instruments can injure your ureters, urethra, or bladder.

Bladder tear (perforation). Bladder perforation rarely happens. If your bladder wall tears, this serious complication may require surgery.

Electric shock. If electricity comes into contact with certain materials, they can shock you or catch fire. But your urologist keeps any flammable material away from the probe. 

Electric burns. Electrosurgery uses electricity and if it contacts metal, fulguration can cause burns. Your urologist keeps metal away and uses non-flammable products during your surgery. Clinics have safety protocols to prevent burns and shocks.

Infections during fulguration. Blood droplets in the air can spread germs if mixed with surgical smoke during fulguration. Your surgeon uses air circulation, face masks, and surgical gloves to prevent infection.

Fulguration of the bladder uses electricity to destroy abnormal tissue and stop bleeding. This electrosurgery treats bladder cancer, interstitial cystitis, and other bladder problems. Often, it’s part of the transurethral resection of bladder tumors (TURBT) procedure to diagnose and treat bladder cancer. Fulguration is generally quick, with a short recovery time, but risks include delayed bleeding or discomfort.

What does fulguration mean in medical terms?

Fulguration uses electricity to kill cancer cells and stop bleeding. The word “fulgur" means lightning in Latin. Doctors use fulguration to get rid of small tumors or other kinds of growths. It can also control bleeding.

How long does bladder fulguration take to heal?

Your recovery time is based on the type of surgery you have and your medical condition. Bladder fulguration typically takes two to four weeks for complete recovery.

What is the success rate of bladder fulguration?

Success rate can depend on which medical condition your bladder fulguration treats. A small study reported about 72% of women were cured of recurrent UTIs after bladder fulguration. Another study reported a 76% survival rate after TURBT surgery to treat bladder cancer. The TURBT procedure included bladder fulguration, too.