title: Current evidence for transurethral laser therapy of non-muscle invasive bladder cancer.
abstract: BACKGROUND
  Bladder cancer is the second most common malignancy of urologic tumors. Back in 1976, lasers were added to the endourological armetarium for bladder tumor treatment. Despite nowadays' standard procedure for staging and treating non-muscle invasive bladder tumor by transurethral resection of bladder tumors (TURB) via a wire loop, laser resection techniques for bladder tumor came back in focus with the introduction of Ho:YAG and not to mention recently Tm:YAG lasers. This review aims to display the current evidence for these techniques.
  
  
  METHODS
  Throughout April 2010, MEDLINE and the Cochrane central register of controlled trials were searched previously for the following terms: "Laser, resection, ablation, coagulation, Nd:YAG Neodym, HoYAG: Holmium, Tm:YAG Thulium and transitional carcinoma, bladder, intravesical."
  
  
  RESULTS
  Eleven articles on Ho:YAG and 7 on Tm:YAG were identified. Searches by Cochrane online library resulted in no available manuscripts.
  
  
  CONCLUSIONS
  Today, Nd:YAG does not play any role in treatment of lower urinary tract transitional cell carcinoma. Ho:YAG and Tm:YAG seem to offer alternatives in the treatment of bladder cancer, but still to prove their potential in larger prospective randomized controlled studies with long-term follow-up. Future expectations will show whether en bloc resection of tumors are preferable to the traditional "incise and scatter" resection technique, in which is contrary to all oncological surgical principles. For the primary targets, here are within first-time clearance of disease, in addition to low in-fields and out-of-fields recurrence rates.
authors.affiliation: Department of Urology and Urologic Oncology, Hannover Medical School (MHH), Carl-Neuberg-Str. 1, 30165, Hannover, Germany.
authors.forename: Mario W
authors.initials: MW
authors.lastname: Kramer
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bach
authors.forename: Mathias
authors.initials: M
authors.lastname: Wolters
authors.forename: Florian
authors.initials: F
authors.lastname: Imkamp
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Gross
authors.forename: Markus A
authors.initials: MA
authors.lastname: Kuczyk
authors.forename: Axel S
authors.initials: AS
authors.lastname: Merseburger
authors.forename: Thomas R W
authors.initials: TR
authors.lastname: Herrmann
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000473:pathology* / Q000601:surgery*; D006695:Holmium; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D009354:Neodymium; D009361:Neoplasm Invasiveness; D013932:Thulium; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
chemical_list: D009354:Neodymium; D013932:Thulium; D006695:Holmium