The diagnostic challenge of suspicious or positive malignant urine cytology findings when cystoscopy findings are normal : an outpatient blue-light flexible cystoscopy may solve the problem
(2021) In Scandinavian Journal of Urology 55(4). p.263-267- Abstract
PURPOSE: To investigate whether outpatient blue-light flexible cystoscopy could solve the diagnostic challenge of positive or suspicious urine cytology findings despite normal white-light flexible cystoscopy results and normal findings on computerized tomography urography, in patients investigated for urothelial cancer.
MATERIAL AND METHODS: In a multicentre study, a total of 70 examinations were performed with the use of blue-light flexible cystoscopy (photodynamic diagnosis) after intravesical instillation of the fluorescence agent hexaminolevulinate. The examination started with a conventional white-light flexible cystoscopy and then the settings were switched to use blue light. Suspicious lesions were biopsied. Afterwards, the... (More)
PURPOSE: To investigate whether outpatient blue-light flexible cystoscopy could solve the diagnostic challenge of positive or suspicious urine cytology findings despite normal white-light flexible cystoscopy results and normal findings on computerized tomography urography, in patients investigated for urothelial cancer.
MATERIAL AND METHODS: In a multicentre study, a total of 70 examinations were performed with the use of blue-light flexible cystoscopy (photodynamic diagnosis) after intravesical instillation of the fluorescence agent hexaminolevulinate. The examination started with a conventional white-light flexible cystoscopy and then the settings were switched to use blue light. Suspicious lesions were biopsied. Afterwards, the patients were interviewed regarding their experience of the examinations.
RESULTS: Bladder cancer was diagnosed in 29 out of 70 (41%) cases, among them 14/29 (48%) had malignant lesions seen only in blue light. The majority had carcinoma
in situ (21/29). Normal findings were seen in 41 cases that underwent BLFC. During the further course, malignancy of the bladder was detected in six cases (9%) and malignancy of the upper urinary tract was detected in one case (1%). The majority of patients (93%) preferred the blue-light flexible cystoscopy performed at the outpatient clinic instead of the transurethral resection under general anaesthesia.
CONCLUSION: Blue-light flexible cystoscopy at the outpatient clinic may be a useful tool to solve unclear cases of a malignant or suspicious urinary cytology suggestive of bladder cancer. The procedure was well tolerated by the patients.
(Less)
- author
- Andersson, Marie LU ; Berger, Marthe ; Zieger, Karsten ; Malmström, Per-Uno and Bläckberg, Mats LU
- publishing date
- 2021-08
- type
- Contribution to journal
- publication status
- published
- keywords
- Aminolevulinic Acid, Carcinoma in Situ, Carcinoma, Transitional Cell, Cystoscopy, Humans, Outpatients, Urinary Bladder Neoplasms/diagnosis
- in
- Scandinavian Journal of Urology
- volume
- 55
- issue
- 4
- pages
- 263 - 267
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:34037496
- scopus:85106528700
- ISSN
- 2168-1813
- DOI
- 10.1080/21681805.2021.1928746
- language
- English
- LU publication?
- no
- id
- 95454bd6-fa9f-4934-999e-237829a8966b
- date added to LUP
- 2022-09-30 10:18:49
- date last changed
- 2024-06-25 05:02:52
@article{95454bd6-fa9f-4934-999e-237829a8966b,
abstract = {{<p>PURPOSE: To investigate whether outpatient blue-light flexible cystoscopy could solve the diagnostic challenge of positive or suspicious urine cytology findings despite normal white-light flexible cystoscopy results and normal findings on computerized tomography urography, in patients investigated for urothelial cancer.</p><p>MATERIAL AND METHODS: In a multicentre study, a total of 70 examinations were performed with the use of blue-light flexible cystoscopy (photodynamic diagnosis) after intravesical instillation of the fluorescence agent hexaminolevulinate. The examination started with a conventional white-light flexible cystoscopy and then the settings were switched to use blue light. Suspicious lesions were biopsied. Afterwards, the patients were interviewed regarding their experience of the examinations.</p><p>RESULTS: Bladder cancer was diagnosed in 29 out of 70 (41%) cases, among them 14/29 (48%) had malignant lesions seen only in blue light. The majority had carcinoma <br>
in situ (21/29). Normal findings were seen in 41 cases that underwent BLFC. During the further course, malignancy of the bladder was detected in six cases (9%) and malignancy of the upper urinary tract was detected in one case (1%). The majority of patients (93%) preferred the blue-light flexible cystoscopy performed at the outpatient clinic instead of the transurethral resection under general anaesthesia.<br>
</p><p>CONCLUSION: Blue-light flexible cystoscopy at the outpatient clinic may be a useful tool to solve unclear cases of a malignant or suspicious urinary cytology suggestive of bladder cancer. The procedure was well tolerated by the patients.</p>}},
author = {{Andersson, Marie and Berger, Marthe and Zieger, Karsten and Malmström, Per-Uno and Bläckberg, Mats}},
issn = {{2168-1813}},
keywords = {{Aminolevulinic Acid; Carcinoma in Situ; Carcinoma, Transitional Cell; Cystoscopy; Humans; Outpatients; Urinary Bladder Neoplasms/diagnosis}},
language = {{eng}},
number = {{4}},
pages = {{263--267}},
publisher = {{Taylor & Francis}},
series = {{Scandinavian Journal of Urology}},
title = {{The diagnostic challenge of suspicious or positive malignant urine cytology findings when cystoscopy findings are normal : an outpatient blue-light flexible cystoscopy may solve the problem}},
url = {{http://dx.doi.org/10.1080/21681805.2021.1928746}},
doi = {{10.1080/21681805.2021.1928746}},
volume = {{55}},
year = {{2021}},
}