In the Interview Dr. Sachin Agrawal

Dr. Sachin Agrawal in Interview

Sachin Agrawal is a specialist in urology in the United Kingdom. The physician accompanied the introduction of the outpatient laser method TULA for the treatment of non-muscle invasive bladder cancer with the LEONARDO Mini Dual Diode Laser manufactured by biolitec® as early as 2012. The technology was approved a year later. The procedure has gained acceptance in recent years and is now established in the British healthcare system. 

Dr. Sachin Agrawal is convinced of the TULA laser therapy and uses the method because it is a simpler, safer, and more cost-effective method for treating bladder cancer. The therapy can be applied without general anesthesia. The prostate tissue is treated with a laser through the urethra. Usually, only a local anesthetic gel is used. According to Agrawal, the TULA laser therapy is well tolerated, as confirmed by over 1000 procedures. The treatment duration is typically 15-20 minutes. 

The urologist explains that the advantages of the TULA treatment lie in the precise removal of bladder cancer using the LEONARDO Mini Dual Diode Laser. Patients experience less pain during treatment compared to conventional high-frequency heat treatment with an electric loop (electrocautery), says Agrawal. The decisive advantage over the Holmium laser is that excellent bleeding control (hemostasis) is ensured even in patients on anticoagulant medication. The laser has 2 different wavelength frequencies (980 nm and 1470 nm) and a mixing function, allowing larger tumors to be treated. The removal of the entire tumor in one piece can also be performed under local anesthesia.

The TULA procedure is particularly suitable for all patients with low-risk non-muscle invasive bladder cancer, which accounts for up to 80% of all bladder cancer cases. These patients often have recurrent tumors and require multiple general anesthetics for treatment with conventional methods, which can now be avoided. This is especially true for older and frail patients with various health problems. The treatment can avoid a hospital stay. It also works well as supportive, palliative care treatment for local control of bladder cancer.

According to Agrawal, patient experiences are consistently positive. The procedure is well tolerated. Patient surveys showed that 99% preferred the treatment compared to previous surgical removal of parts or the entire bladder under general anesthesia or high-frequency treatment with an electrocautery. Most described a pain score of 1-2 out of 10. Interestingly, it was also found that patients who could watch their treatment had reduced anxiety and a better understanding of the therapeutic treatment of bladder cancer, according to physician Agrawal.