High feasibility and safety of office-based transurethral laser ablation for recurrent non-muscle invasive bladder cancer: a single-center experience.

Objective: To evaluate the feasibility, safety, and early oncological outcomes of office-based transurethral laser ablation (TULA) for recurrent non-muscle invasive bladder cancer (NMIBC). Methods: We retrospectively reviewed 53 patients undergoing their first TULA for recurrent NMIBC at the University Hospital Centre Zagreb from March 2024 to February 2025. Inclusion criteria comprised histologically confirmed NMIBC recurrence suitable for outpatient laser ablation. Exclusion criteria included carcinoma Results: The median patient age was 68 years, and 54.7% were male. Most tumors were pTa (94.3%) and low-grade (92.5%); 90.6% measured <1 cm. TULA was completed successfully in 94.3% of cases, with minimal peri-procedural complications (1.9%). At 3 months, the recurrence rate was 38.8%. Univariate analysis linked recurrence with older age, higher Charlson Comorbidity Index, and male gender. In multivariate analysis, male gender remained the only independent predictor (aOR 4.29; p=0.034). No patient progressed to muscle-invasive disease. Conclusions: Office-based TULA is a highly feasible, safe, and cost-effective alternative for selected patients with small recurrent low-grade NMIBC, offering significant procedural and economic advantages over transurethral resection. Although early recurrence rates are notable in this high-risk cohort, oncological safety appears acceptable. Male gender may predict early recurrence, warranting further investigation in larger prospective studies.