Holmium:YAG laser treatment of recurrent superficial bladder carcinoma: initial clinical experience.
OBJECTIVE
To review our initial experience with the holmium laser in patients with recurrent superficial bladder cancer.


METHODS
We treated 41 patients having 71 recurrent superficial transitional-cell tumors of the bladder between December 1994 and September 1997 using the holmium:YAG laser under local anesthesia. The laser treatment was carried out as a part of the follow-up flexible cystoscopy protocol, and topical anesthesia was used. The mean follow-up was 14 months (range 3-33 months).


RESULTS
There were 13 recurrent tumors in the treated area and 38 recurrences in the untreated areas. Of interest, a subgroup of 10 patients were treated before 1994 with cystodiathermy and later on with the holmium:YAG laser at various times during their follow-up. The local recurrence rate with cystodiathermy was 32% compared with 10% after laser treatment (P = 0.39). A questionnaire study of 33 patients showed complete satisfaction with the treatment. Only 2 (6%) elected to have a further procedure under general anesthesia. In the series, 83% scored their pain as 2 or less of 10 on a visual analog scale.


CONCLUSIONS
The absence of complications, high patient satisfaction, and ability to be used in the outpatient setting make the holmium:YAG laser an attractive alternative in the treatment of recurrent superficial cancer of the bladder.
Syed
H A
HA
Department of Urology, Leighton Hospital, Crewe, UK.
Biyani
C S
CS
Bryan
N
N
Brough
S J
SJ
Powell
C S
CS
D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000601:surgery*; D003972:Diathermy; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D010146:Pain / Q000209:etiology; D017060:Patient Satisfaction; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000601:surgery* / Q000628:therapy