To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 9 sources, which was discussed by the committee. The evidence included 6 case series, 2 non-randomised comparative studies and 1 case report, and is presented in table 2 of the overview. Other relevant literature is in the appendix of the overview.
The specialist advisers and the committee considered the key efficacy outcomes to be: patient-reported outcome measures, tumour ablation, reduction in tumour recurrence rates and survival.
The specialist advisers and the committee considered the key safety outcomes to be: bleeding, pain and bladder perforation.
Patient commentary was sought but none was received.
The committee was informed that this procedure is used in 2 distinct groups:
for people with small superficial tumours, when the intention is to completely ablate the tumour
for symptom control in people with more advanced disease who are unfit for, or unwilling to have, surgery.
The technology used in this procedure is evolving.
A chemical may be instilled into the bladder to aid with tumour detection, using a blue light.
The committee was informed that it may not always be necessary to stop anticoagulant or antiplatelet therapy before this procedure.