A national snapshot survey of transurethral laser ablation for non-muscle-invasive bladder cancer
Year: 2026
Type: article
Study design: Observational Study
Abstract: Objective: Non-muscle invasive bladder cancer (NMIBC) is traditionally managed with transurethral resection of bladder tumour (TURBT) and intravesical therapy. Although effective, TURBT carries morbidity, particularly in frail or comorbid patients. Outpatient transurethral laser ablation (TULA) is an emerging alternative with fewer complications. However, national data on patient selection and practice patterns are limited. This survey provides a contemporary overview of TULA use in the United Kingdom. Materials and methods: A structured questionnaire was distributed to UK urologists, assessing current TULA practice, selection criteria, and barriers to service delivery. Results: Responses were received from 105 urologists. Of these, 60 (57%) reported performing TULA, averaging 348 procedures annually. Indications included low-grade, small (<1 cm) superficial recurrences, and primary treatment in patients unsuitable for TURBT due to comorbidities. Additional considerations were anticoagulated patients and challenging lesion sites, such as the bladder dome. Reported limitations included technical challenges with lesion visibility during flexible cystoscopy, difficulties at the bladder neck, and service constraints related to funding and laser equipment availability. Conclusion: TULA is a promising treatment for carefully selected NMIBC cases, particularly in frail populations. Standardised selection criteria, prospective monitoring of outcomes, and establishment of a national registry are required to guide safe practice, inform clinical guidelines, and support equitable service provision. Level of evidence: Level 4 cohort study
Source: Journal of Clinical Urology
Authors: Anas Khan, Alvaro Bazo, Andrew Moon, Bhavan Rai, Chandrasekharan Badrakumar, Gokul Kanda Swamy, Hamid Abboudi, Henry Lazarowicz, Joseph John, Oliver Fuge, Omar El-Taji, Rahul Gujadhur, Rajan Veeratterapillay, Robert Calvert, Sachin Agrawal, Shabi Ahmad, Vishwanath Hanchanale, Eva Bolton, Rakesh Heer
Institutions: Ashford and St Peter's Hospitals NHS Foundation Trust, Nottingham University Hospitals NHS Trust, Freeman Hospital, South Tees Hospitals NHS Foundation Trust, Morriston Hospital, Imperial College Healthcare NHS Trust, Royal Liverpool University Hospital, University of Exeter, NHS England, University Hospitals Plymouth NHS Trust, The Christie NHS Foundation Trust, Imperial College London
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7129779193