What question did this study set out to answer?

This research aims to assess the safety, effectiveness, and practicality of low-power holmium laser en bloc resection of bladder tumors as an alternative to traditional methods.

March 28, 2026Open Access

Initial Experience of Low-Power Holmium Laser En Bloc Resection of Urinary Bladder Tumors in Comparison With TURBT: A Case Series

Key Points

This research aims to assess the safety, effectiveness, and practicality of low-power holmium laser en bloc resection of bladder tumors as an alternative to traditional methods.
Observational study design
Participants divided into two groups for HoEBRBTs and TURBT
Intraoperative and postoperative data collection
10 patients in TURBT group experienced obturator reflex, none in HoEBRBT group
2 bladder perforations occurred in TURBT group, none in HoEBRBT group
Mean catheterization duration was lower in HoEBRBT group (1.78 days) compared to TURBT (2.78 days)
Mean hospital stay was shorter for HoEBRBT group (2.48 days) versus TURBT (3.24 days)
Higher percentage of detrusor muscle presence in HoEBRBT specimens (92%) compared to TURBT (78%)

Abstract

Purpose: Urinary bladder neoplasms are among the most prevalent urologic cancers. Historically, these tumors have been treated with conventional transurethral resection of bladder tumors (cTURBT), which has widely recognized limitations and potential complications. Accordingly, alternative approaches have been explored. In this study, we implemented low-power holmium laser en bloc resection of bladder tumors (HoEBRBTs) and evaluated its safety, effectiveness, and practicality.Materials and Methods: A total of 100 individuals participated in this observational study. Fifty individuals underwent low-power HoEBRBTs, and the remaining 50 underwent conventional TURBT. The study was approved by the institutional ethics committee, and written informed consent was obtained from all participants. Intraoperative and postoperative data were collected.Results: During TURBT, 10 patients experienced obturator reflex; no such events occurred in the holmium laser en bloc resection of bladder tumor (HoEBRBT) group. In the TURBT group, 2 patients had bladder perforations, whereas none occurred in the HoEBRBT group. One patient in the TURBT group required postoperative clot evacuation, and no patients in the HoEBRBT group required clot evacuation. The mean catheterization duration was 2.78±1.02 days in the TURBT group and 1.78±0.68 days in the HoEBRBT group. The mean hospital stay was 3.24±0.59 days in the TURBT group and 2.48±0.54 days in the HoEBRBT group. Detrusor muscle was present in 78% of specimens in the TURBT group and 92% of specimens in the HoEBRBT group.Conclusion: For non–muscle-invasive bladder cancer, low-power holmium laser en bloc resection appears to be safe, with a low risk of complications. The higher rate of detrusor muscle-positive specimens suggests that the technique is feasible and effective.

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