Blue light cystoscopy (bladder scope)

Blue light cystoscopy (bladder scope) is an advanced procedure used to detect and remove bladder cancer tumors. During the procedure, a urologist uses a special camera called a cystoscope equipped with both white and blue light, along with a diagnostic dye called Cysview® (hexaminolevulinate HCl). Under blue light, cancer cells absorb the dye and glow bright pink, helping doctors identify tumors that may be difficult to see with standard white-light cystoscopy alone. Blue light cystoscopy is most often used for non-muscle invasive bladder cancer, which remains confined to the bladder’s inner lining.

At Penn Medicine, an accurate and timely bladder cancer diagnosis is the first step toward exceptional care. Our bladder cancer specialists use advanced diagnostic and therapeutic tools, including blue light cystoscopy with Cysview, to detect cancer more precisely and guide treatment decisions. We offer coordinated care, experienced specialists, and timely access to innovative bladder cancer therapies.

Blue light cystoscopy with Cysview can help doctors:

• Locate smaller, hard-to-find, or flat tumors that standard cystoscopy may miss
• Find and remove bladder cancer tumors during the same procedure
• Spare healthy tissue when removing bladder cancer tumors
• More accurately target cancer cells and prevent recurrence

About an hour before the procedure, your care team injects Cysview into the bladder through a catheter. Cancer cells absorb the dye, making them easier to identify during the exam.

During the cystoscopy, your doctor first checks the bladder using standard white light to look for visible tumors. The cystoscope is then switched to blue light, which causes cancerous tissue that has absorbed Cysview to glow pink while healthy tissue appears blue. If abnormal tissue is found, your doctor may use a small wire loop to remove it or take a small tissue sample (biopsy) during the same procedure for further testing. This method is known as a transurethral resection of bladder tumor (TURBT).

Is blue light cystoscopy safe?

Research has shown that blue light cystoscopy is generally safe. Our bladder cancer surgeons can help you decide if it’s right for you.

Blue light cystoscopy may be recommended for people who need further evaluation for bladder cancer or follow-up care after treatment. You may be a candidate if:

• Your doctor suspects bladder cancer based on your symptoms or test results
• You need monitoring after treatment for non-muscle invasive bladder cancer
• Standard cystoscopy has not provided enough information
• Prior treatments, such as chemotherapy, have caused inflammation that makes tumors harder to see under white light alone

Blue light cystoscopy is typically a same-day procedure. You may receive local anesthesia, sedation, or general anesthesia, depending on whether it’s performed in the office or operating room.

In an office setting, your doctor may use numbing gel without sedation. You’ll remain awake and may feel pressure or a strong urge to urinate. If a biopsy or tumor removal is planned, the procedure is commonly done in an operating room under sedation or general anesthesia.

It’s common to experience mild burning with urination, urinary urgency, or small amounts of blood in the urine for a short time after blue light cystoscopy. Most people recover quickly and return to normal activities within a day or two, though recovery time may vary if tissue is removed.

After your procedure, your Penn Medicine care team will review the findings with you and discuss any next steps, including additional testing, surveillance, or treatment as needed.