For a larger bladder tumor, TURBT allows the urologist to remove as much visible tumor as safely possible through the natural urinary passage, without an external incision. A specialized scope is passed through the urethra into the bladder, and a surgical loop or other instrument is used to carefully remove the tumor in sections. Tissue from the tumor and often the underlying bladder wall is sent to pathology. This helps determine the tumor type, grade, and whether it has grown into deeper bladder layers. Larger tumors may require a more extensive procedure, and occasionally a second TURBT or additional cancer treatment is recommended based on the findings.