FLUORESCEIN ANGIOGRAPHY OF THE BLADDER - TECHNIQUE AND RELEVANCE TO BLADDER-CANCER AND INTERSTITIAL CYSTITIS PATIENTS

Purpose: Fluorescein angiography has been used in the study of bleedin g vessels, neovascularity, tumors and ischemic tissues in a variety of disorders. This pilot study was designed to evaluate the feasibility, safety and relevance of this interesting technology for the evaluatio n of bladder wall vessels in patients with interstitial cystitis and b ladder cancer. Materials and Methods: Five patients with National Inst itutes of Health defined interstitial cystitis symptoms and 10 with bl adder cancer were studied during cystoscopy while they were under gene ral anesthesia. A yellow-green barrier filter (520 nm.) was placed ove r the cystoscope eyepiece and a blue exciter filter (465 nm.) was atta ched to the Light source. Patients received a 5 ml. bolus of 10% fluor escein intravenously. Results: After hydrodistension, glomerulations i n interstitial cystitis patients were more prominent with fluorescein angiography and occurred in the venule phase. Areas of papillary trans itional cell tumor and carcinoma in situ developed a brilliant yellow- green fluorescence. Adjacent normal urothelium was nonfluorescent and provided a contrasting dark background facilitating the detection of a ll lesions. No allergic reaction or other adverse effect related to th e fluorescein injection was observed. Conclusions: These unique observ ations in a Limited number of patients suggest that fluorescein angiog raphy of the bladder is a safe and simple procedure. This preliminary report underscores the relevance of fluorescein angiography in the det ection of bladder tumor and offers a new approach to the evaluation of bladder wall vessels in interstitial cystitis patients.