Jim,
Procedures vary a bit with different docs, different patients, and the specifics. That said, let me add a little bit to the mix.
An INITAL screening and work up includes taking a history, a cystoscope exam and CT scans with and without contrast. These allow the doc to compare the complaint with what can be SEEN on the surface of the bladder and other organs AND deeper into the tissues.
THEN, the decision to examine further can be made.
If something suspicious (a tumor or growth) is found or suspected, a biopsy is needed to determine what IT is, and if cancerous, what is the grade and the stage. The biopsy material goes to the pathologist for that determination. The process of obtaining the material the TUR or TURBT - TransUurethral Resection of Bladder Tumor.
IF the pathologist rates a tumor as cancerous, s/he will examine the sample to see if the whole tumor was removed. In other words, was the tumor surrounded by normal cells (clean margins) OR is it likely that part of the tumor was left behind ? If there is any question, a second TURBT will take place to remove a bit more of the surrounding tissue and get the whole tumor.
Only at this point - with a full understanding of the situation - can further treatment decisions be made. It appears that you are just now about to reach this point.
As to your 6 questions, my comments do not disagree with Sara Anne, but do differ slightly. Again, " Procedures vary a bit with different docs, different patients, and the specifics" , and my experiences differ a bit. It appears to me that...
1. You do not yet seem to have had a full initial workup.
2. Only the superficial sample was sent to path. The tumor shown on CT has not been examined.
3. I have been offered a spinal for 3 TUR procedures by 2 different anesthesiologists. I prefer a general to a spinal, so I decline. Obviously, with some docs it is an option. Talk to your doc.
4. After 3 of the last 4 TUR procedures I have had a catheter overnight. It depends on the doc, and how much residual bleeding is anticipated. I have "clogged" from blood clots - unable to urinate, which is NOT fun at all - and had the 3 AM run to ER to have the bladder clots pumped out. Trust the doc to decide. We all hate being cathed. (or are grateful when it is necessary). It is funny how quickly our perspective on things urological changes after diagnosis.
5. The upcoming TURBT, I assume, will provide initial info about the tumor found on CT, and may be intended to learn further about the papillary tumors. Ask the doc. Expect TURBTs on a regular basis as part of ongoing monitoring and prevention.
6. Grade and Stage are important. Size, for a change, is just a number.
Best, Jack