The use of the neodymium:YAG (Nd:YAG) laser in urology is still in its infancy. To date, the most widely published application of this laser is in the treatment of bladder carcinoma. We have utilized the Nd:YAG laser in 23 treatments for superficial bladder tumors. The laser has both advantages and shortcomings, which are thoroughly addressed. In our hands the laser has been a safe instrument for the treatment of these lesions, although we do not recommend its use for tumors > 3 cm. We have treated two patients with invasive disease one week prior to planned cystectomy. In one case, no residual tumor was found at cystectomy, while the second patient had viable tumor only in an untreated area. Two patients were successfully treated with the laser for intractable bladder bleeding, one each with primary and secondary bladder tumor.
Seven patients with condylomata acuminata were treated with laser therapy. All had excellent results without complication. One patient with urethral bleeding secondary to trauma was treated without success, while one patient with a urethral hemangioma was well treated with the Nd:YAG laser. Thus the Nd:YAG laser would appear to have a place in the urologic armamentarium, hut whether it is cost-effective for widespread use remains to be seen.