Detection of early bladder cancer by 5-aminolevulinic acid induced porphyrin fluorescence

J Urol. 1996 Jan;155(1):105-9; discussion 109-10.


Purpose: We determined whether the sensitivity of detecting dysplasia or early bladder cancer can be improved by 5-aminolevulinic acid induced porphyrin fluorescence.

Materials and methods: A 3% 5-aminolevulinic acid solution was instilled intravesically before cystoscopy in 104 patients. The 5-aminolevulinic acid induced porphyrin fluorescence was excited by violet light from a krypton ion laser (wavelength 406.7 nm.).

Results: The sensitivity of the fluorescence cystoscopy (96.9%) was significantly (p < 0.0001) greater than that of white light cystoscopy (72.7%). There was no impact on specificity.

Conclusions: Due to the high sensitivity of the procedure fluorescence guided biopsies are recommended instead of random biopsies.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravesical
  • Aged
  • Aminolevulinic Acid* / administration & dosage
  • Biopsy
  • Carcinoma in Situ / diagnosis*
  • Carcinoma, Transitional Cell / diagnosis*
  • Cystoscopy / methods
  • Female
  • Fluorescence
  • Humans
  • Male
  • Porphyrins / metabolism
  • Sensitivity and Specificity
  • Urinary Bladder / metabolism
  • Urinary Bladder / pathology*
  • Urinary Bladder Neoplasms / diagnosis*


  • Porphyrins
  • Aminolevulinic Acid