Initial Experience of Low-Power Holmium Laser En Bloc Resection of Urinary Bladder Tumors in Comparison With TURBT: A Case Series

Purpose: Urinary bladder neoplasms are among the most prevalent urologic cancers. Historically, these tumors have been treated with conventional transurethral resection of bladder tumors (cTURBT), which has widely recognized limitations and potential complications. Accordingly, alternative approaches have been explored. In this study, we implemented low-power holmium laser en bloc resection of bladder tumors (HoEBRBTs) and evaluated its safety, effectiveness, and practicality.Materials and Methods: A total of 100 individuals participated in this observational study. Fifty individuals underwent low-power HoEBRBTs, and the remaining 50 underwent conventional TURBT. The study was approved by the institutional ethics committee, and written informed consent was obtained from all participants. Intraoperative and postoperative data were collected.Results: During TURBT, 10 patients experienced obturator reflex; no such events occurred in the holmium laser en bloc resection of bladder tumor (HoEBRBT) group. In the TURBT group, 2 patients had bladder perforations, whereas none occurred in the HoEBRBT group. One patient in the TURBT group required postoperative clot evacuation, and no patients in the HoEBRBT group required clot evacuation. The mean catheterization duration was 2.78±1.02 days in the TURBT group and 1.78±0.68 days in the HoEBRBT group. The mean hospital stay was 3.24±0.59 days in the TURBT group and 2.48±0.54 days in the HoEBRBT group. Detrusor muscle was present in 78% of specimens in the TURBT group and 92% of specimens in the HoEBRBT group.Conclusion: For non–muscle-invasive bladder cancer, low-power holmium laser en bloc resection appears to be safe, with a low risk of complications. The higher rate of detrusor muscle-positive specimens suggests that the technique is feasible and effective.