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Diagnosis of urothelial carcinoma of the bladder using fluorescence endoscopy
Author(s) -
Zaak Dirk,
Karl Alexander,
Knüchel Ruth,
Stepp Herbert,
Hartmann Arndt,
Reich Oliver,
Bachmann Alexander,
Siebels Michael,
Popken Gralf,
Stief Christian
Publication year - 2005
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2005.05604.x
Subject(s) - bladder cancer , medicine , endoscopy , disease , urology , genitourinary system , cancer , hypericin , carcinoma in situ , bladder neoplasm , oncology , surgery , pharmacology
SUMMARY Bladder cancer is a frequent disease and represents the second most common genitourinary neoplasm. Although many aspects of the management of superficial bladder cancer are now well established, significant challenges remain, which influences patient outcome. Early detection and treatment of recurrent disease is required to optimize bladder preservation, reduce patient morbidity, and increase quality of life and survival. Fluorescence endoscopy, often referred to as ‘photodynamic diagnosis’ (PDD), with intravesical application of photosensitizing agents, has been developed to enhance the early detection of bladder cancer. There is growing evidence that PDD using 5‐aminolaevulinic acid (ALA), hexyl‐ALA ester or hypericin enhances the detection of bladder cancer, particularly of high‐grade flat lesions. Furthermore, transurethral resection of bladder tumour under fluorescence guidance reduces the risk of recurrent tumours. However, the impact on the progression of disease remains unclear and must be investigated in prospective randomized trials.