[Value of the photodynamic method in the diagnosis of superficial bladder tumors]

Abstract

Photodynamic diagnosis (PDD) is one of most precise method of neoplasms recognition. The aim of the study was to estimate the value of 5-amino levulinic acid in diagnosis of superficial bladder tumours. Since 1996 to March 2004, 597 cystoscopies were performed with 5-amino levulinic acid in 151 patients with superficial bladder tumours (102 men and 49 women) aged 19-87 years old. 132 pts were treated by PDD after transurethral resection of bladder tumours (TURB). 749 specimens were taken from mucosa during PDD. Before PDD 50 ml of of 5-amino levulinic acid solution was instilled into bladder. As a source of ultraviolet light (UV) D--Light Storz xenon lamp (405 nm) was used. In 16 pts single PDD was performed in 38 double and in 97 PDD was performed three or more times (3 to 7). All pts were observed 12 months before and after PDD. In 102 from 151 pts in white light cystoscopy (WL) no changes in the bladder mucosa were found. In both kind of light (WL and UV) changes were not observed in 44 pts (29.1%). In 58 pts in WL no changes were observed but in UV places of neoplastic changes in the mucosa were found. In these cases the presence of superficial bladder tumours was confirmed. These changes were pathologically confirmed only in UV in 26 pts. Ta (G1 and G2) changes were confirmed in 52 pts (21 in WL and additionally 31 in UV). T1 changes were confirmed in UV in 26 pts but in WL in 25 pts. In 3 pts T2 changes were confirmed in both UV and WL. Cystoscopy in ultraviolet light (photodynamic diagnosis--PDD) with 5 amino levulinic acid gives more precise diagnosis of superficial bladder tumours then the one in standard white light. Cystoscopy performed to diagnose bladder tumours and early recurrence and new focus of tumours recognition without PDD is less effective. Introduction of superficial bladder tumours photodynamic diagnosis into health care system reduced recurrences and improves results of treatment.