Recent developments in fluorescence cystoscopy: do novel agents bring a benefit?
OBJECTIVE
In flat bladder cancer and carcinoma in situ, and in multifocal papillary cancer, some smaller lesions may be overlooked at cystoscopy. For 10 years fluorescence cystoscopy has been promoted to solve these problems without wider acceptance. New fluorophobes now promise better clinical applicability.


RESULTS
In prospective multicenter studies fluorescence cystoscopy shows significant improvement in the detection of flat bladder cancer and carcinoma in situ. It also permits more reliable identification of all neoplastic lesions with multifocal tumors, hence more precise removal and as a consequence lower recurrence rates.


CONCLUSIONS
New agents bring a significant benefit. Hexyl-aminolevulinate offers more rapid urothelial accumulation, better fluorescence contrast and less photobleaching than previously used fluorophobes. It is simple to use in everyday practice and has a favorable toxicity profile.
Schmidbauer
Jörg
J
Department of Urology, Medical University of Vienna, Vienna, Austria.
Marberger
Michael
M
D000622:Aminolevulinic Acid / Q000031:analogs & derivatives; D000873:Anthracenes; D002278:Carcinoma in Situ / Q000175:diagnosis*; D003558:Cystoscopy / Q000379:methods*; D005453:Fluorescence; D005456:Fluorescent Dyes; D006801:Humans; D010569:Perylene / Q000031:analogs & derivatives; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis*
D000873:Anthracenes; D005456:Fluorescent Dyes; D010569:Perylene; C004965:hypericin; D000622:Aminolevulinic Acid; C419924:5-aminolevulinic acid hexyl ester