Treatment of invasive bladder cancer with a neodymium:YAG laser.

In a controlled setting a neodymium:YAG laser is capable of producing a transmural coagulation of the bladder wall without perforation. A total of 21 patients with known muscle-invading bladder cancer underwent treatment with transurethral endoscopic application of neodymium:YAG laser energy. One patient suffered a sigmoid colon perforation that possibly was treatment-related but no other complications were observed. Four of 5 patients with clinical stage B1 and 3 of 6 with stage B2 lesions have had normal post-treatment biopsies. Local tumor control has been achieved in only 1 of 4 patients with a clinical stage C tumor and none of 6 with metastatic cancer, although palliative debulking was accomplished.