Transurethral Resection of Bladder Tumors Using Holmium Laser: An Observational Study

Background Bladder cancer ranks as the ninth most frequently diagnosed malignancy globally. Although conventional treatment, i.e., transurethral resection of the bladder tumor (TURBT), remains the gold-standard procedure for early-stage bladder cancer, it carries well-documented risks such as bleeding, perforation, and prolonged catheter dependence. In contrast, holmium laser resection promises several theoretical benefits, namely, lower thermal damage to surrounding tissues, reduced incidence of the obturator nerve reflex, and superior control of intraoperative bleeding. Methodology This cross-sectional observational study was conducted at the Department of Urology, Mahatma Gandhi Medical College and Research Institute, Puducherry, between December 2021 and June 2023. In total, 24 patients older than 18 years and diagnosed with superficial bladder carcinoma (Tis, Ta, T1, N0, M0) underwent holmium laser-assisted transurethral resection. Operative time, complication rates, duration of catheterization, length of hospital stay, and histological results were systematically recorded and analyzed. Results The study population comprised 62.5% males and 37.5% females. Hematuria was the most common presenting symptom (58.3%). The majority of tumors were located in the right lateral wall (37.5%) and posterior wall (25.0%). Single lesions predominated (70.8%). The median operative time was 32.50 minutes, with a median catheterization time of two days and a hospital stay of 1.50 days. Complications included bladder perforation (8.3%) and obturator reflex (12.5%). Tumor staging showed 62.5% T1 and 37.5% Ta stages, with 58.3% classified as low-grade tumors. Conclusions Holmium laser-assisted TURBT demonstrated acceptable operative outcomes with relatively low complication rates, shorter hospital stays, and effective tumor resection. The technique appears to be a viable alternative to conventional TURBT for superficial bladder carcinoma management.