Transurethral laser destruction using contact Nd: YAG laser (TULD) was performed on 70 occasions in 44 patients with primary bladder cancer for the purpose of cure from February 1984 to August 1987. In the 70 occasions, indication of the TULD was evaluated, and we never experienced diturbance of the ureteral orifice and the intra-mural ureter, and obtulator reflex. The cancers were classfied and staged in accordance with the Japanese Urological Association. The indication of the TULD was judged by surgeons with criteria as follows: degree of difficulty of manipulation, degree of destruction of the cancers, and bleeding during the TULD. Features of the cancers, for which the TULD was judged as suitable, were summarized as follows: 1.0n cystoscopical findings, the form of the cancer was superficial, the number of cancers were under the number of four and the sizes of the cancers were under 3cm in diameter. 2.0n pathological findings, the grade of the cancers reached grade II and the stage of the cancers reached stage T1. It may be concluded that the indication of TULD would be similar to TUR-Bt, but TULD might be superior to TUR-Bt from the points of view of damage of the ureteral orifice and obtulator reflex.
