One of the challenges in managing transitional cell carcinoma of the bladder as well as for evaluation of hematuria is the presence of positive cytology or positive UroVysion without visible disease on cystoscopic examination or ureteroscopic examination.
When upper tract tumor is suspected evaluation is oftentimes challenging unless the tumor is large.
A new study using fairly new technology called photodynamic diagnosis (PDD) following administration of 5–ALA demonstrated that a significant number of tumors that are not visible during routine cystoscopy and ureteroscopy can be detected using PDD.
This is an exciting opportunity to improve care of patients with bladder cancer and upper tract transitional cell carcinoma of the ureter and the renal pelvic through early diagnosis and treatment.
PDD can potentially improve our ability to cure patients especially with upper tract transitional cell carcinoma and to prevent disease progression as well as preserve renal function by timely treatment of noninvasive disease potentially with minimally invasive treatment options.