Blue Light Cystoscopy: Photodynamic Diagnosis of the Bladder Explained

What is photodynamic diagnosis of the bladder?

In photodynamic diagnosis of the bladder, a photosensitiser is instilled into the bladder before the procedure. Cells that take it up accumulate fluorescent molecules. When the bladder is illuminated with blue light of a defined wavelength, those areas emit red fluorescence, while normal urothelium looks blue. The aim is to help the surgeon see lesions that are flat or small and can be missed in white light.

Blue light does not replace white-light cystoscopy. The surgeon switches between both modes during the same procedure, which is why the camera and light source must handle each equally well. Clinical indications, drug handling and the choice of patients are decisions for the treating urologist and the drug's labelling.

Hexvix cystoscopy and the clinical use case

Richard Wolf describes System blue as a PDD solution for endourology that is matched to the photosensitiser Hexvix and is intended to improve tumour fluorescence and the detection of non-muscle invasive bladder carcinoma. The photosensitiser is a pharmaceutical product with its own regulatory status, so a department planning Hexvix cystoscopy needs to confirm availability and approval with the relevant UAE authorities.

This is also a workflow topic. Instillation time, patient preparation and darkening of the room all affect planning, and the endoscopy suite must be able to switch between modes without long delays. For cystoscope basics see what is a cystoscope and flexible cystoscope guide.

Equipment for PDD cystoscopy

A PDD system needs a camera and light source designed for blue light, a telescope that transmits it, and a light cable that does not degrade the signal. System blue combines the ENDOCAM Logic 4K controller, the PENDUAL blue HD camera head, the ENDOLIGHT LED blue light source, PANOVIEW blue telescopes and a special blue fibre light cable. The same camera head also serves for white-light endoscopy, so one head can cover both modes.

Look at these details when you compare PDD solutions: how the filter is integrated in the camera head, whether the light source needs a warm-up time, and whether all components are validated as one set. System blue uses an LED light source with constant illumination over its service life, and the fibre light cable is autoclavable.

• ENDOCAM Logic 4K controller with 3840 × 2160 / 4096 × 2160 output
• PENDUAL blue HD camera head with 1080p sensor, angle adjustable from 0 to 90 degrees
• ENDOLIGHT LED blue light source
• PANOVIEW blue telescopes and blue fibre light cable

Imaging modes and what the surgeon sees

In the bluePDD SIM mode on System blue, tumours fluoresce red; in Color Contrast mode they appear magenta. The modes are switched from the camera head so the surgeon does not have to leave the field. Image and video storage helps with documentation and teaching.

Ask suppliers to show the modes on a bladder model in a darkened room, because image quality in PDD depends on filter, light and optics together. If you already own a 4K platform, check which components can be reused and which are specific to blue light; Beckfinity can advise on compatibility with ENDOCAM Logic 4K and core nova integration.

Buying considerations and next steps

Before purchase, define the expected number of cases, whether PDD will be used in the main OR or a procedure room, and how cystoscopes and light cables will be reprocessed. Consider training for nurses and surgeons and a service agreement that covers the light source and camera head. Other urology equipment is listed in the urology equipment supplier guide.

To discuss a PDD configuration for your department in Dubai, Abu Dhabi or elsewhere in the GCC, view the Richard Wolf System blue or request a consultation.