Outpatient holmium laser treatment for recurrent low-grade superficial bladder cancer under local anesthesia

Minerva Urol Nefrol. 2016 Apr;68(2):204-8. Epub 2015 Feb 6.


Background: The aim of this paper is to analyze the results of a prospective study conducted on a cohort of patients undergoing outpatient holmium laser fulguration. The "gold standard" treatment of superficial bladder cancer is transurethral resection, although in recent years improvements in laser technology and endoscopy equipment have allowed further therapeutic alternatives.

Methods: This is a descriptive study of a cohort of 37 patients with low-risk recurrent superficial bladder cancer undergoing holmium laser fulguration after bladder instillation of local anesthesia. The study included patients with a history of low-risk primary superficial bladder cancer with papillary tumor recurrence, tumor size ≤10 mm, fewer than 5 tumors, absence of carcinoma in situ, negative cytology, no coagulation disorders and no local anesthesia allergies. Demographic variables, previous history of transurethral resection, safety and oncological results after fulguration were analyzed using the SPSS software. Statistical analyses include calculating mean and frequency, and Kaplan-Meier curve for recurrence.

Results: Mean age of the patients was 69.2 years with 86.5% being male. The number of tumors was 1.5±0.8 and the overall average size of 5.5±2.7 mm. The mean duration of the endoscopic procedure was 12±4.3 minutes. Hundred percent of patients had scores on the Visual Analogue Scale ≤3. There was only one case of hematuria, who required hospitalization. After a median follow-up period of 13 months, there was a 35.1% recurrence rate with one case of tumor progression.

Conclusions: Holmium laser treatment of recurrent low-risk superficial bladder tumor is a safe and effective alternative, but long-term clinical trials are necessary to increase the current scientific evidence base.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia, Local*
  • Cohort Studies
  • Electrocoagulation
  • Female
  • Humans
  • Laser Therapy / methods*
  • Lasers, Solid-State*
  • Male
  • Middle Aged
  • Prospective Studies
  • Urinary Bladder Neoplasms / surgery*
  • Urologic Surgical Procedures / methods*