The role of lasers in the management of bladder tumors

The objective of this review is to assess the role of laser technology in the management of non-muscle-invasive bladder cancer (NMIBC).

A literature review was conducted using the Medline database with the keywords bladder and laser. Relevant articles in English and French were selected to produce a narrative review focusing on the main risks and applications of lasers in urology.

The lasers currently employed for NMIBC treatment include Ho:YAG, continuous and pulsed Tm:YAG, thulium fiber, GreenLight KTP or LBO, and diode lasers. Two surgical techniques are currently used for endoscopic laser management of NMIBC: en bloc resection and photovaporization. Laser settings according to surgical technique and generator type, as well as oncological, histological, and safety outcomes, are discussed in this review. Overall, lasers occupy an important role in NMIBC management, offering oncological results comparable to other energy sources while providing a more favorable perioperative safety profile.

Despite favorable outcomes, further studies are required to better define the role of lasers in NMIBC management through randomized controlled trials with long-term follow-up. Such evidence would help clarify the specific indications of each laser modality and optimize the surgical treatment of NMIBC with laser technology.