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A national snapshot survey of transurethral laser ablation for non-muscle-invasive bladder cancer

Lookup NU author(s): Andrew Moon, Bhavan Rai

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Abstract

© British Association of Urological Surgeons 2026Objective: 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


Publication metadata

Author(s): Khan A, Bazo A, Moon A, Rai B, Badrakumar C, Swamy GK, Abboudi H, Lazarowicz H, John J, Fuge O, El-Taji O, Gujadhur R, Veeratterapillay R, Calvert R, Agrawal S, Ahmad S, Hanchanale V, Bolton E, Heer R

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Urology

Year: 2026

Pages: epub ahead of print

Online publication date: 17/02/2026

Acceptance date: 09/12/2025

ISSN (print): 2051-4158

ISSN (electronic): 2051-4166

Publisher: Sage Publications Ltd

URL: https://doi.org/10.1177/20514158251410996

DOI: 10.1177/20514158251410996


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