Bladder cancer is the 10th most common cancer worldwide, with non-muscle-invasive bladder cancer (NMIBC) accounting for approximately 75 to 80 percent of cases at diagnosis. The standard treatment for NMIBC is transurethral resection of bladder tumor (TURBT), but this conventional method has several limitations:

Fragmented tumor resection can hinder accurate pathological assessment.

Absence of detrusor muscle in specimens occurs in about 10 to 51 percent of cases, compromising staging accuracy.High recurrence rates, with studies reporting recurrence in a significant proportion of patients within 5 years.Complications such as bleeding, obturator nerve reflex (ONR), and bladder perforation are associated with conventional TURBT.

To address these challenges, Holmium Laser En Bloc Resection of Bladder Tumors (HoLEBT) has been introduced as an alternative technique. HoLEBT offers several potential advantages

En bloc tumor excision allows for intact specimen retrieval, facilitating precise pathological evaluation.Higher rates of detrusor muscle presence in resected specimens, enhancing staging accuracy.Reduced intraoperative complications, including lower incidences of ONR and bladder perforation.Shorter catheterization and hospitalization times, improving patient recovery.Comparable or improved recurrence-free survival rates compared to conventional TURBT.

Despite these promising outcomes, there is a need for more high-quality randomized controlled trials to conclusively determine the efficacy and safety of HoLEBT compared to conventional TURBT. This study aims to fill this gap by evaluating recurrence-free survival, perioperative outcomes, and specimen quality differences between the two techniques.