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Photodynamic methods in urological practice
Article published in Urologia Polska 2004/57/4.

authors

Aleksander Sieroń 1, Artur Pietrusa 2, Michał Szyguła 1, Wiesław Duda 2, Bogusław Wojciechowski 1, Mariusz Adamek 1, Aleksandra Kawczyk-Krupka 1, Wojciech Cebula 1, Witold Zieleźnik 1, Tomasz Biniszkiewicz 1
1 Ośrodek Diagnostyki i Terapii Laserowej Kliniki Chorób Wewnętrznych, Angiologii i Medycyny Fizykalnej Śląskiej Akademii Medycznej w Bytomiu
Kierownik kliniki: prof. dr hab. Aleksander Sieroń
2 SPZOZ Szpital Urologiczny im. Prof. Emila Michałowskiego w Katowicach
Ordynator: dr n. med. Wiesław Duda

keywords

bladder, bladder cancer, photodynamic diagnosis, photodynamic therapy

summary

Fluorescence diagnosis is an innovative diagnostic option based on detection of distinctive fluorescence of normal and pathological tissue. Fluorescent diagnosis can be used in two ways – aurofluorescence diagnosis (LIF – laser induced fluorescence) obtained through fluorescence of endogenous tissue fluorophores after excitation with UV light, and photodynamic diagnosis (PDD) – fluorescence enhanced by previous administration of photosensitizers. Fluorophores selectively accumulate in higher concentration in pathological than in normal tissues. Many compounds are used as photosensitizers: e. g. porphyrins, their derivatives or precursors (as 5-aminolevulinic acid, ALA). Fluorescent diagnosis seems to be a sensitive examination method in patients strongly suspected of neoplasmatic process, not disclosed by standard endoscopic methods. The method can detect very early stages of neoplasm or precancerous lesions. It can be also applied postoperatively. Photodynamic therapy is based on the cytotoxicity of light-activated photosensitizers accumulated in the cancer tissue; it initiates sequential photooxidation of neoplasmatic tissue. Fluorescence procedures in urological practice – photodynamic diagnosis and therapy – are preferably used as adjuvant method after transurethral electroresection of the bladder tumours (stage pT1).
Short review of basic physical methods, diagnostic devices and hitherto obtained clinical effects of fluorescent therapy was presented.

references

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correspondence

Aleksander Sieroń
Klinika Chorób Wewnętrznych, Angiologii i Medycyny Fizykalnej ŚAM
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