Name of the Procedure:

Common name: Blue Light Cystoscopy
Technical term: Adjunctive blue light cystoscopy with fluorescent imaging agent
HCPCS Code: C9738

Summary

Blue Light Cystoscopy is a diagnostic procedure that uses a special imaging agent and blue light to enhance the visualization of the inner lining of the bladder. By illuminating the bladder with blue light, the imaging agent makes cancerous tissues stand out more clearly.

Purpose

Medical Conditions: This procedure is mainly used to detect bladder cancer.
Goals: To identify and evaluate suspicious areas that might not be visible under standard white light cystoscopy. This helps in more accurate diagnosis and effective treatment planning.

Indications

Symptoms:

• Blood in the urine
• Persistent bladder pain
• Frequent urination with no apparent cause

Patient Criteria:

• Patients with a history of bladder cancer
• Patients exhibiting symptoms indicative of bladder cancer

Preparation

Pre-Procedure Instructions:

• Fasting for a specific period before the procedure, typically 6-8 hours
• Temporary adjustment of certain medications, as advised by the physician

Diagnostic Tests:

• Initial urine tests
• Ultrasound or CT scan for preliminary evaluation

Procedure Description

1. Anesthesia: Local, regional, or general anesthesia may be administered, depending on the specific case.
2. Cystoscopy: A cystoscope (a thin, tube-like instrument) is inserted through the urethra into the bladder.
3. Imaging Agent: A fluorescent imaging agent is then delivered into the bladder via the cystoscope.
4. Visualization: The bladder is examined under both white and blue light. The blue light causes cancerous cells to fluoresce and appear distinct from normal tissue.
5. Documentation: Images are captured for documentation and further analysis.

Equipment:

• Cystoscope
• Fluorescent imaging agent
• Blue light source

Duration

The procedure typically takes about 30-60 minutes.

Setting

Performed in a hospital or outpatient surgical center.

Personnel

• Urologist
• Nurse
• Anesthesiologist or nurse anesthetist (if anesthesia is required)

Risks and Complications

Common Risks:

• Mild pain or discomfort during urination post-procedure
• Blood in urine

Rare Risks:

• Infection
• Allergic reactions to the imaging agent
• Perforation of the bladder

Benefits

• Enhanced detection of bladder cancer
• More accurate diagnosis
• Better treatment planning and outcomes

Recovery

Post-Procedure Care:

• Drink plenty of fluids to flush out the imaging agent
• Avoid strenuous activities for 24 hours
• Follow prescribed pain management regimen if required

Recovery Time:

• Usually, patients can resume normal activities within 24-48 hours.
• Follow-up appointments may be scheduled to discuss results.

Alternatives

Other Options:

• Standard white light cystoscopy
• Urinary cytology
• Imaging studies such as CT scans or MRIs

Pros and Cons of Alternatives:

• White Light Cystoscopy: Less detailed visualization but commonly available.
• Urinary Cytology: Non-invasive but less accurate.
• Imaging Studies: Non-invasive but might miss early-stage cancer.

Patient Experience

During the Procedure:

• Mild discomfort or pressure as the cystoscope is inserted.
• Some patients may experience a slight burning sensation.

Post-Procedure:

• Some discomfort or burning during urination.
• Patients are advised to rest and stay hydrated.
• Pain is usually manageable with over-the-counter medications.

Pain management and comfort measures are prioritized to ensure patient comfort throughout the entire process.