Blue Light Cystoscopy

Better Urologic Cancer Detection

Dr. Ben Ristau uses ultrasound to guide a transperineal prostate biopsy.

Dr. Ben Ristau uses ultrasound to guide a transperineal prostate biopsy.

UConn Health urologists are at the forefront of new and improved approaches to detecting prostate and bladder cancer, the first and fourth most common forms of cancer among men.

When a patient needs a prostate biopsy, the urology team is among the first in New England to practice a new method called transperineal prostate biopsy, which offers distinct advantages in safety and precision over previous protocols.

Historically when a biopsy was needed, urologists would pierce the rectal wall with a needle to take a biopsy of the prostate. Known as a transrectal biopsy, the procedure carries a small but real risk of infection. Roughly three out of every 100 men who undergo a transrectal biopsy end up in the intensive care unit with sepsis, a potentially life-threatening condition related to the body’s response to infection.

“The other problem with the transrectal approach is the difficulty accessing some portions of the prostate,” says Dr. Peter Albertsen, chief of UConn Health’s Division of Urology. “The angle of the biopsy needle traversing the probe makes it hard to hit the apex of the prostate. With the transperineal approach, we are finding it much easier to access regions of the prostate which historically have been difficult to reach with a transrectal probe.”

With transperineal biopsy, the needle that retrieves the tissue sample goes not through the rectum but the soft tissue just outside and past it, guided by the latest ultrasound technology for a clear, real-time view.

“Fortunately there are no nasty blood vessels, there are no nasty nerves, and it’s a straight shot to get” to the prostate, Albertsen says. “And by not going through the rectum, we anticipate the risk of sepsis going to zero.”

For bladder cancer detection, the urologists are the first in central Connecticut to use a new blue light cystoscopy technology to illuminate tumors in the bladder and identify smaller cancers earlier than ever before.

Certain tumors are hard to detect using traditional white light cystoscopy, but turn pink under the enhanced imaging provided by the blue light.

“Recurrence rates for bladder cancers are somewhere in the 50–70% range. Using blue light cystoscopy, depending on the tumor type, can reduce the risk of recurrence by about 40%, which means fewer trips to the operating room,” says Dr. Benjamin Ristau, UConn Health’s surgical director of urologic oncology.