Diagnosis of urothelial carcinoma of the bladder using fluorescence endoscopy.
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.
Zaak
Dirk
D
Department of Urology, Klinikum Grosshadern, Ludwig-Maixmilians-University of Munich, Germany. Dirk.Zaak@med.uni-muenchen.de
Karl
Alexander
A
Knüchel
Ruth
R
Stepp
Herbert
H
Hartmann
Arndt
A
Reich
Oliver
O
Bachmann
Alexander
A
Siebels
Michael
M
Popken
Gralf
G
Stief
Christian
C
D000622:Aminolevulinic Acid / Q000009:adverse effects / Q000191:economics; D003365:Costs and Cost Analysis; D003558:Cystoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D006801:Humans; D008856:Microscopy, Fluorescence / Q000009:adverse effects / Q000191:economics / Q000379:methods; D017319:Photosensitizing Agents / Q000009:adverse effects / Q000191:economics; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis* / Q000191:economics
D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid