[Laser therapy of superficial tumors of the bladder]

Based on the treatment with Nd-YAG laser of 109 superficial bladder tumors (52 initial cases and 57 recurrences), herein we report on its indications, technical aspects, and clinical advantages. In order to evaluate the difference between laser therapy and TUR, three groups were studied to compare both techniques. 1) We evaluated the incidence of tumor recurrence in 27 cases submitted to laser therapy and 26 cases submitted to TUR. At 2 years no significant differences were observed relative to tumor recurrence or progression for both groups. 2) We evaluated bladder parietal involvement for each technique. All but one of 109 cases that had been submitted to laser therapy had preserved initial bladder capacity. Biopsies performed in areas post-laser therapy (31) and post-TUR (24), and with the resector loop in 22 cases, revealed no histologic difference between both groups (replacement fibrosis and elastic fibers). 3) We evaluated the incidence of urethral stenosis after laser therapy (22) and TUR (55). Urethral stricture was significantly lower (4.5%) for those treated with laser than for those treated by TUR (16.3%). On the basis of the overall (109 cases) and the partial (study groups) results, we consider laser treatment of superficial bladder tumors to be limited to single, less than 2-3 cms, or small, multiple initial or recurrent neoformations.