Endoscopic therapy of superficial bladder cancer in high-risk patients: Holmium laser versus transurethral resection

Abstract

Many lasers are widely used in urological surgery for several applications. Their use to treat the superficial bladder cancer (SBC) is safe and minimally invasive. The Holmium:YAG (Ho:YAG) laser represents the pinnacle of laser technology in Urology. The authors carried out this study on safety, efficacy, complication rates, postoperative catheterization time, and hospital stay of high-risk patients who underwent Ho:YAG vs. transurethral resection (TUR). Two groups of high-risk patients with SBC and comorbidities underwent either Ho:YAG or TUR. Different clinical aspects of the tumours and recurrences were considered. No significant difference between the two groups was noted regarding number, progression of grade and stage and place and time of recurrences. In the Ho:YAG patients, perioperative complications occurred at a lower percent than in the TUR group. Also, in 54% of patients, the catheter was removed within 24 hours; 76% had a postoperative hospital stay of 24 to 48 hours. In the TUR patients: 4% had the catheter removed within 24 hours and 6% left the hospital within 24 to 48 hours. In SBC treatment, Ho:YAG and TUR were equally as effective; the Ho:YAG laser was associated with shorter catheterization time and hospital stay. These Ho:YAG features could be advantageous from a psychological standpoint, particularly for elderly, high-risk patients and in terms of cost:benefit ratios.