Office-based holmium-YAG TULA shows feasibility and safety for recurrent NMIBC in a high-risk cohort
This retrospective cohort study included 53 patients undergoing their first office-based transurethral laser ablation (TULA) for recurrent non-muscle invasive bladder cancer (NMIBC). The intervention utilized a holmium-YAG laser under local anesthesia at a University Hospital Centre Zagreb, office-based setting, with transurethral resection serving as the comparator. The median patient age was 68 years; 54.7% were male, 94.3% had pTa tumors, 92.5% were low-grade, and 90.6% measured less than 3 cm.
The study assessed feasibility, safety, and early oncological outcomes. The procedure was described as highly feasible, safe, and cost-effective with acceptable oncological safety. However, early recurrence rates were notable in this high-risk cohort, and male gender may predict early recurrence.
Safety data regarding adverse events, serious adverse events, discontinuations, and tolerability were not reported. Key limitations include the single-center experience and the high-risk nature of the cohort. The authors note a need for further investigation in larger prospective studies. Practice relevance suggests office-based TULA is a highly feasible, safe, and cost-effective alternative for selected patients with small recurrent low-grade NMIBC, offering significant procedural and economic advantages over transurethral resection.
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