Blue Light Cystoscopy

Physician holding a model of a bladder and explaining Blue Light Cystoscopy procedure

UC Irvine Department of Urology offers a revolutionary diagnostic technique called Blue Light Cystoscopy.

Every year, more than 79,000 Americans face the possibility of a bladder cancer diagnosis. Seven out of 10 bladder cancers are caught at an early stage.

Blue Light Cystoscopy (BLC) with Cysview is a diagnostic procedure used by healthcare professionals to detect carcinoma in the bladder. Research has shown that Blue Light Cystoscopy with Cysview improves detection and removal of early stage bladder cancer, often with greater accuracy than a cystoscopy using white light alone.

Cysview is an optical imaging agent, called hexaminolevulinate (HAL) hydrochloride, used to detect non-muscle invasive bladder cancer (NMIBC) including carcinoma in situ (CIS). Cysview is used in conjunction with the KARL STORZ Photodynamic Diagnostic (PDD) system to perform BLC. The procedure has been performed on over 450,000 patients worldwide and is available in over 120 US institutions, including the UCI Urology.

How a Cystoscopy is Performed

During a cystoscopy, a thin, tube-like telescope is used to examine the bladder’s lining closely for abnormal growths or suspicious areas. During the procedure, tissue samples may be removed for testing. A standard cystoscopy uses a regular white light to help the doctor visually assess the bladder. The white light is effective for detecting larger, non-muscle bladder cancer, but smaller cancerous areas might be too hard to spot.
With the innovative Blue Light Cystoscopy technology, the cystoscope is equipped with white and blue light, and an optimal imaging medication that is absorbed by cancer cells is also administered. Under the blue light, tumors and lesions glow pink against the healthy tissue, which appears blue.

This level of detection makes it easier for your doctor to see–and completely remove–abnormal growths. With a more complete removal of the bladder cancer, patients may experience lowered chances of recurrence with this technology.

Female doctor speaking to patient about upcoming Blue Light Cystoscopy procedure
Female doctor shaking the hand of a recovering male patient after Blue Light Cystoscopy procedure

The Benefits of Blue Light Cystoscopy

BLC is the only FDA-approved technology that:

  • Detects more Ta/T1 bladder cancer lesions than white light cystoscopy alone
  • One or more additional Ta or T1 bladder cancer lesions were detected by BLC with Cysview in 16.4% of patients compared to white light alone
  • 34.6% Patients who recurred with CIS were detected with BLC only
  • Detects more NMIBC, resulting in improved tumor resection, since tumors are resected in the same TURBTS procedure
  • Helps lead to fewer recurrences of bladder cancer
  • Allows for better patient management decisions

Your doctor might recommend a Blue Light Cystoscopy in cases of:

  • An initial standard cystoscopy detects early stage bladder cancer
  • Multiple low-grade tumors
  • Re-evaluation after tumor removal or cancer treatment
  • Positive blood tests for the presence of cancer cells

BLC with Cysiew can be used in patients:

  • With no history of bladder cancer who need a biopsy
  • Who have never been evaluated with Cysview at the time of checkups for tumor recurrence
  • With multiple NMIBC
  • With positive urinary cytology with no visible tumors with standard cystoscopy

What to Expect

During a BLC procedure, a catheter tube is inserted into the bladder through the urethra and is used to place the Cysview solution into the bladder. Cancer cells, if present, will absorb the solution. Once the solution has been in the bladder for an hour, the surgeon will begin surgery by using a scope to inspect the bladder with a regular white light. The surgeon will repeat the inspection with a blue light to identify bladder cancer cells. Under a blue light, cancer cells and lesions will appear vivid pink, while the healthy tissue will remain blue.

If NMIBC cells are present, the surgeon is able to immediately perform a resection (to remove the diseased tissue). BLC with Cysview allows the surgeon to remove only the cancerous tissue, and decreases the need for a total cystectomy (which is removal of the entire bladder). A biopsy may also be taken to test abnormal areas.

Many patients are able to go home after just a short time. However, you should plan to rest for the remainder of the day. Pain or discomfort while urinating is normal for a couple of days. If you had any bladder tissue removed during the procedure, you may also notice blood in your urine for a few days. If you have any trouble urinating or experience any other side effects, talk to your doctor.

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