Background: A prospective study was carried out to assess the efficacy and patient tolerability of electromotive drug administration (EMDA) of local anesthetic (LA) for outpatient flexible cystoscopy biopsy and cystodiathermy of recurrent low grade, non-muscle invasive (G1–2pTa) transitional cell carcinoma of the bladder. Patients and Methods: Over a 24 month period, 31 patients with proven G1–2pTa bladder can-cer underwent 33 biopsy and cystodiathermy procedures for recurrences (≤ 5mm diameter; maximum of 3 tumors) using EMDA LA. Biopsy results, patient satisfaction and pain scores (0–10), recurrence and progression rates were recorded. Results: The median pain score was 1 and 94% of patients would choose EMDA LA again. There were no complications. A histological diagnosis was possible in 27/33 procedures. No patient had a recurrence at the site of cystodiathermy or disease progression. Conclusions: EMDA LA allows effective local anesthesia of the bladder and enables satisfactory biopsy and cystodiathermy of small bladder cancer recurrenc-es in an outpatient setting.