This is like a flexible cystoscopy. A narrow tube is inserted into the bladder through the tube that carries urine wee out from the bladder (urethra). You will have had this procedure before and know about it.

For TULA, the camera has a laser to destroy the cancer cells.

It is for patients diagnosed with non-muscle invasive bladder cancer. This is cancer that is only in the lining of the bladder. The procedure is mostly used for very small, recurrent (repeated) bladder tumours.

This procedure takes place in the urology department at Wansbeck General Hospital. It takes place under local anaesthetic. You can go home on the same day.

You may have a biopsy (sample of tissue) taken first. This is to confirm if the cancer has come back. This will reduce the risks linked with repeat anaesthetics. The laser will then be used to completely remove any abnormal tissue and stop any bleeding.

There is a small risk of a urine infection that may need antibiotics.

You may have a mild burning sensation while weeing for a short time after.

If you have ongoing bleeding, you may need a short hospital stay for monitoring with a catheter (drainage tube in the bladder).

Bleeding can happen 2 to 3 weeks after the procedure. This means you may have an infection.

There is a risk that the bladder tumours come back. You would need more treatment in this case.

You don’t need to do anything special. You can eat and drink as normal.

If you take blood thinning medication (like warfarin or clopidogrel), please contact us on 01670 529314 before your appointment. You can continue to take aspirin.

If you have symptoms of a urine infection (needing to go often, getting desperate to go, a burning sensation when weeing), please contact us on 01670 529314 before your appointment. We will arrange for a urine test. Your procedure may need to be postponed until the infection has cleared.

If there is evidence of infection on the day, the procedure may have to be cancelled.

In the procedure room, you will have to wear a pair of laser protection glasses throughout, as a precaution.

You will be asked to lie on the examination couch.

You will be awake for the procedure. Local anaesthetic gel will be used to minimise discomfort.

Once the flexible telescope has been passed into the urethra (water pipe), a biopsy will be taken first.

The laser fibre will then be passed through the flexible telescope. The procedure is usually painless.

The procedure can cause some bleeding. If there is a lot, you may need a catheter put in to allow your bladder to empty.

The procedure should take about 10 to 20 minutes. It can vary between patients.

You can go home straight after. We will give you a single dose of antibiotic before leaving.

You will need to drink plenty of fluids. You should try to drink at least two litres daily for two to three days afterwards. This will help to dilute your urine and reduce any discomfort when you wee. It will help keep the bladder flushed. This means blood clots are less likely to develop and the urine continues to flow easily.

You can take paracetamol if you have any discomfort.

One of our nurse specialists will phone you 24 hours after to ask how you are feeling. They will check if there has been a lot of bleeding overnight.

A letter will go to your GP and you will receive a copy. You will also get a letter for your next follow-up appointment.

You should try to stay active as this will help speed up your recovery.

 You will need to watch out for a urine infection. If you develop a fever, if your urine becomes cloudy or thick, you may have an infection. You should contact your GP as you may require a course of antibiotics.

If you have any questions, please contact on 01670 529314.

If you develop severe bleeding, you should go to a hospital emergency department.