It used be available only rigid form and was used in the OR during TURBT. Now, it is my understanding that KARL STORZ has developed flexible blue light cystoscopy so it can be done while you are awake just as regular white light cystoscopy. So, the access to blue light cystoscopy has become easier and with less risk. If you can have your insurance company pays for it, why not everyone with high risk NMIBC should get blue light cystoscopy to improve the prognosis. The American Urological Association (AUA)–Society of Urologic Oncology (SUO) guidelines for managing NMIBC state that “in a patient with NMIBC, a clinician should offer blue light cystoscopy at the time of TURBT, if available, to increase detection and decrease recurrence. (Moderate Recommendation; Evidence Strength: Grade
”
See below the consensus statement by urologists in USA for the use of blue light flexible cystoscopy.
nature.com/articles/s41585-019-0184-4#:~:text=Blue%20light%20cystoscopy%20(BLC)%20with,NMIBC)%20and%20reduces%20recurrence%20rates.
Before I had followed up on blue light cystoscopy. A year ago, I called the sales department of Photocure, which sells a patented chemical solution (Cysview) which is instilled in the bladder before blue light cystoscopy can be used. They told me it costed $1,000 per an administration. Incidentally, in Japan, 5-aminolevulinic acid in tablet form 2 hours blue light cystoscopy. Karl Strorz video camera system was used in the OR with TURBT.
No clinical studies have been done to compare the chemical solution (Cysview) vs oral tablets of 5-aminolevulic acid.
