Efficacy and safety profile of TULA for recurrent non-muscle-invasive bladder cancer among urology outpatients at an NHS district general hospital
Keywords:
Laser, bladder cancer, outpatient, recurrence, progressionAbstract
Objectives: This case series aimed to evaluate the efficacy and safety of transurethral laser ablation (TULA) for recurrent non-muscle-invasive bladder cancer (NMIBC) at a UK district general hospital. The main objective was to investigate the burden of morbidity from TULA by recording bleeding, pain, and bladder perforation. Also, to determine the rate of recurrence and progression of NMIBC by the first follow-up cystoscopy. Methods: This was a retrospective study reviewing patients treated with TULA during the initial 11 months of implementation. Non-probability sampling was used to recruit patients who met the inclusion criteria. Recurrence was defined as a bladder tumour that reoccurred after the first TULA. Progression was defined as a bladder tumour that evolved into a higher grade, higher stage, or spread to other sites. The data was analysed using descriptive statistics, with results presented in tables and graphs. Findings: Twenty-six patients, with an average age of 77.63, underwent 30 procedures. Low-grade G2pTa was the most common previous histology. The average treatment lasted 64.73 seconds. Seven out of 14 patients had no recurrence. Six patients (42.86%) developed recurrence, and the most frequent location was off-site (4). Only one patient had progression confirmed with metastatic deposits in the small bowel and passed away seven weeks post-TULA. Conclusions: Tula is a safe outpatient intervention for treating recurrent NMIBC early and conveniently, avoiding the need for TURBT in high-risk patients and releasing theatre capacity.
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