Narrow band imaging‐guided diode laser ablation in recurrent low‐grade non‐muscle‐invasive bladder cancer

Background Low‐grade non‐muscle‐invasive bladder cancer (NMIBC) is characterized by high recurrence rates, resulting in repeated interventions and intensive surveillance. Office‐based transurethral laser ablation (TULA) performed under local anesthesia is a minimally invasive alternative to transurethral resection, and narrow band imaging (NBI) may improve tumor visualization and treatment precision. This study aimed to evaluate the efficacy and safety of NBI‐guided office‐based diode laser ablation for recurrent low‐grade NMIBC and to identify factors associated with recurrence. Methods A retrospective review of 71 patients with recurrent Ta low‐grade NMIBC was conducted who underwent diode laser ablation in an outpatient clinic. All patients had negative urine cytology prior to treatment. Demographic, clinical, and tumor‐related variables were recorded. Recurrence was defined as histologically confirmed tumor reappearance on follow‐up cystoscopy. Univariable and multivariable logistic regression analyses were performed to identify predictors of recurrence. Results Recurrence occurred in 44 patients (62%). Patients with recurrence were younger (median 52.5 vs. 65 years, p < 0.001) and had lower rates of comorbidities (47.7% vs. 74.1%, p = 0.029). A higher proportion of patients with more than three original tumors was observed in the recurrent group (40.9% vs. 11.1%, p = 0.013). On multivariable analysis, younger age (OR = 0.79, 95% CI: 0.67–0.93, p = 0.006), higher number of ablated tumors (OR = 2.5, 95% CI: 1.14–5.85, p = 0.02), and presence of comorbidities (OR = 324.8, 95% CI: 2.99–352.0, p = 0.016) were independently associated with recurrence. Conclusion NBI‐guided office‐based diode laser ablation is a safe and effective option for managing recurrent low‐grade NMIBC.