Thulium laser resection via a flexible cystoscope for recurrent non-muscle-invasive bladder cancer: initial clinical experience

OBJECTIVE To present our initial experience of thulium laser resection via a flexible cystoscope for recurrent non-muscle-invasive bladder cancer (ThuRBT), as transurethral resection for bladder tumour (TURBT) is regarded as the reference standard for treating this disease, but alternative laser resection or ablation is suitable especially for recurrent tumours. PATIENTS AND METHODS From January 2005 to October 2005, 32 patients with early recurrent bladder tumour (recurrent within a year after TURBT) were treated with ThuRBT via a flexible cystoscope. The follow-up included urine analysis, ultrasonography and cystoscopy every 3 months. RESULTS All patients were treated successfully with ThuRBT in one session, with no bladder haemorrhage, obturator nerve reflex or vesicle perforation. Randomized biopsies taken after surgery on and adjacent to the resection surface revealed no residual tumours. The mean (range) tumour diameter was 1.5 (0.5-3) cm and the mean operative duration was 25 (15-35) min. During the first year of follow-up, local and heterotopic recurrences were found in three and six patients, respectively. The accumulated recurrence rates at 3, 6 and 12 months were 9%, 22% and 28%, respectively. CONCLUSIONS ThuRBT is a reliable therapy with minimal morbidity and invasiveness for selected patients with bladder cancer.