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Flexible Cystoscopy with Blue Light Imaging

Photodynamic blue-light cystoscopy with hexaminolevulinate to detect bladder cancer lesions.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is Flexible Cystoscopy with Blue Light Imaging?

Hexaminolevulinate is instilled into the bladder where it accumulates preferentially in malignant cells and converts to fluorescent protoporphyrin IX. Under 380–440 nm blue light, malignant areas glow red while normal urothelium appears blue.

Compared with white-light cystoscopy, blue-light imaging detects 20–30% more carcinoma in situ and reduces recurrence after transurethral resection. It is recommended for high-risk non-muscle-invasive bladder cancer surveillance.

Flexible blue-light cystoscopy enables office-based detection without anaesthesia, improving patient comfort while preserving diagnostic yield.

Symptoms

Painless visible hematuria
Recurrent urinary tract infection
Positive urine cytology
Surveillance after bladder cancer resection
High-grade non-muscle-invasive bladder cancer
Carcinoma in situ suspicion
Persistent irritative voiding symptoms

Risk Factors

Cigarette smoking
Occupational aniline dye exposure
Chronic bladder inflammation
Schistosomiasis
Cyclophosphamide therapy
Pelvic radiation
Family history of bladder cancer

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Visible hematuria episode
  • Positive cytology with negative white-light cystoscopy
  • Suspicious lesion on imaging
  • Recurrence after intravesical therapy
  • Surveillance interval reached
  • Persistent irritative symptoms

Treatment Methods

01
Bladder instillation of hexaminolevulinate solution
02
Flexible cystoscopy with white-light inspection first
03
Switch to blue light to identify fluorescent lesions
04
Targeted biopsy of fluorescent areas
05
Transurethral resection guided by blue light
06
Intravesical BCG or chemotherapy as adjuvant
07
Routine surveillance protocol with cytology and cystoscopy

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Üroloji Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.