Holmium:YAG laser vaporization of recurrent papillary tumours of the bladder under local anaesthesia.
OBJECTIVE
To evaluate holmium:YAG laser vaporization of papillary tumours of the bladder, focusing on surgical technique, patients' satisfaction, complications and cost-effectiveness when using the technique under local anaesthesia as an outpatient procedure.


METHODS
In all, 52 consecutive patients with recurrent papillary tumours of the bladder were scheduled for holmium:YAG laser vaporization under local anaesthesia using a flexible cystoscope. The number of papillomas and total operative duration was recorded. Patients and surgeons were asked to complete a questionnaire about the procedure.


RESULTS
In all, 197 papillomas were successfully vaporized in 88 operations, with a median operative duration of 15 min (5 min per papilloma) and no patient needed treatment under general anaesthesia. Most patients (86%) had no pain (as reported during standard cystoscopy) and none of the procedures was stopped because of pain. All patients would undergo the treatment again, compared with a standard transurethral resection of bladder tumour. The five surgeons rated the procedure as easy in most patients (78%) and difficult in a few (6%). The total cost for the outpatient procedure was less than that for standard treatment.


CONCLUSIONS
This study clearly indicates that holmium:YAG laser vaporization of superficial bladder tumours is feasible, easy and fast, with a high degree of patient satisfaction, and it seems to be an attractive alternative to standard treatment. The procedure has some clear positive socio-economic perspectives in both the short- and long-term.
Division of Urology, Department of Surgery, Viborg Hospital, DK-8800 Viborg, Denmark.
Morten
M
Jønler
Lars
L
Lund
Søren
S
Bisballe
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D006801:Humans; D017075:Laser Coagulation / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000191:economics / Q000601:surgery*; D010212:Papilloma / Q000191:economics / Q000601:surgery*; D017060:Patient Satisfaction; D001749:Urinary Bladder Neoplasms / Q000191:economics / Q000601:surgery*