Abstract
Up to 50-70 % of superficial bladder carcinomas recur. To improve the surgical results of transurethral resection the photodynamic diagnostic with 5-aminolevulinic acid is used. 5-aminolevulinic acid specifically accumulates in malignant cells leading to fluorescence under blue light cystoscopy. After intravesical instillation before transurethral resection also lesions like Carcinoma in situ, hardly to recognize in conventional cystoscopy, are noticed due to their fluorescence. Thus a significantly higher number of tumors can be diagnosed and resected. Also the recurrence rate decreases statistically significant. Long-term results with 5-aminolevulinic acid showed recurrence-free survival rates of 71 % versus 45 % after conventional transurethral resection under conventional white light. A recent cost analysis showed that photodynamic diagnostic reduces the number of stays in hospital thus also leading to cost reduction. Because of 18,000 newly diagnosed diseases in Germany per year this could result in remarkable saving possibilities of the health system.
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