Holmium : YAG laser treatment of recurrent superficial bladder carcinoma: Initial clinical experience

Purpose: To review our initial experience with the holmium laser in patient s with recurrent superficial bladder cancer. Patients and Methods: We treated 41 patients having 71 recurrent superficia l transitional-cell tumors of the bladder between December 1994 and Septemb er 1997 using the holmium:YAG laser under local anesthesia. The laser treat ment was carried out as a part of the follow-up flexible cystoscopy protoco l, 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 recurren ces in the untreated areas. Of interest, a subgroup of 10 patients were tre ated before 1994 with cystodiathermy and later on with the holmium:YAG lase r at various times during their follow-up. The local recurrence rate with c ystodiathermy was 32% compared with 10% after laser treatment (P = 0.39). A questionnaire study of 33 patients showed complete satisfaction with the t reatment. Only 2 (6%) elected to have a further procedure under general ane sthesia. In the series, 83% scored their pain as 2 or less of 10 on a visua l analog scale. Conclusions: The absence of complications, high patient satisfaction, and a bility to be used in the outpatient setting make the holmium:YAG laser an a ttractive alternative in the treatment of recurrent superficial cancer of t he bladder.