Impact of Thulium Laser En Bloc Resection on Catheter-Related Bladder Discomfort after Bladder Tumor Surgery

To assess how thulium laser en bloc resection of bladder tumor (ERBT) compares with conventional transurethral resection of bladder tumor (TURBT) regarding their influence on catheter-related bladder discomfort (CRBD) in individuals with bladder cancer. From January 2022 through December 2024, we retrospectively collected demographic and clinical information from patients with bladder cancer. The study included 79 patients who underwent conventional TURBT and 58 who received thulium laser ERBT. Demographic characteristics and outcome measures were documented; analysis focused on CRBD frequency and intensity at 1, 6, and 24 hours after surgery, pain scores at these same time points, and patient satisfaction 24 hours post-procedure. The groups did not differ meaningfully in terms of age, sex distribution, number of tumors, tumor dimensions or positioning, or length of the operation (P > 0.05). Histopathological assessment indicated that detrusor muscle was present more often in ERBT specimens than in TURBT specimens (P = 0.04). At both 1 and 6 hours postoperatively, the ERBT cohort exhibited reduced CRBD occurrence and severity compared with the TURBT cohort (P < 0.001). However, the difference was no longer statistically significant at 24 hours (P = 0.17). Postoperative pain, as measured by VAS scores, was notably lower in the ERBT arm at 1 hour (P = 0.001) and at 6 hours (P = 0.02); by 24 hours, this gap had closed (P = 0.08). Patient satisfaction at 24 hours post-surgery was significantly lower in the ERBT group than in the TURBT group (P = 0.02). Furthermore, the ERBT approach was associated with significantly less intraoperative hemorrhage and a shorter postoperative irrigation period (P = 0.001). The time an indwelling catheter remained in place did not differ significantly between the study arms (P = 0.07). These data suggest that thulium laser ERBT, compared with standard TURBT, substantially reduces the frequency and intensity of CRBD, diminishes postoperative discomfort, and yields superior patient satisfaction. That said, given the single-center, retrospective design, corroboration through expansive, prospective, multicenter investigations is warranted.