Display Patient Information Leaflets

You have been asked to attend for a TULA® procedure. TULA® stands for Trans Urethral Laser Ablation and is essentially a flexible cystoscopy using a form of Laser treatment. Using the Laser will allow you to have the procedure done under local anaesthetic in the Out Patient Department and in most cases you should be able to go home the same day following the procedure. During the TULA® procedure if a suspicious area or a tumour is identified then a biopsy (tissue sample) may be taken and sent for pathology (i.e. to look under the microscope). The laser will then be used to completely remove any abnormal tissue and stop any bleeding.

What happens on the day of the procedure 

1. There is no special preparation required, you can eat and drink as normal on the day of the procedure.

2. You will need to bring a urine sample with you for analysis prior to undergoing the procedure.

3. If the urine analysis shows evidence of infection the TULA® procedure will have to be cancelled to prevent a septic episode.

Details of the procedure

1. This is a cystoscopy examination of the interior of the urinary bladder.

2. A fine flexible telescopic tube will be passed through your urethra (water pipe) to examine your bladder. Sterile water will be instilled at the same time to aid the inspection of the bladder lining.

3. You will be awake throughout the procedure.

4. In order to minimise discomfort, an anaesthetic gel will be applied into the urethra.

5. A biopsy (a sample) will be necessary if there is a bladder lesion/suspicious area.

6. The laser fibre is passed through the flexible telescope and the tumour is destroyed. Minimal discomfort is usually experienced during the procedure.

7. Whilst in the procedure room you will be asked to wear a pair of laser protection glasses throughout the procedure as a Health & Safety precaution. These will be provided by the nurse assisting throughout the procedure.

8. Approximate time of the procedure varies between 10 and 20 minutes.

9. You will have been counselled regarding any blood thinning medication (e.g. Clopidogrel/Warfarin/Apixaban) at your initial appointment; if however you have any doubts or questions please contact the Urology Department.

10. You will be able to go home immediately after the procedure.

11. You may be given a single dose of chemotherapy, (Mitomycin), immediately post procedure. This will be instilled directly into the bladder and will need to remain in situ for one hour. You will need to pass urine prior to being discharged.

12. Following the procedure a letter will be sent to your GP informing him/her of the procedure, the outcome and the next appointment.

Before you go home

We will tell you how the procedure went and you should:

1. Make sure you understand what has been done.

2. Ask the surgeon/clinician if everything went as planned.

3. Let the staff know if you have any discomfort.

4. Provide a urine sample that will be checked by a member of the nursing team.

Ways to prevent post procedure complications

1. Drink plenty of fluid; you should aim to drink at least two litres daily for two or three days following your procedure. This will dilute your urine and reduce any discomfort when you pass urine. It also helps to keep the bladder flushed, so that blood clots are less likely to develop and the urine continues to flow easily.

2. Take paracetamol/ibruprofen if you have any discomfort and not contraindicated with any other medication that you may take.

3. Try to stay active; this will help speed up your recovery.

4. Watch out for a urine infection. If you develop a fever, of if your urine becomes cloudy or thick, you could have an infection. You should contact your GP and have a course of antibiotics.