Contemporary Role for Blue Light Cystoscopy Across the Bladder Cancer Disease Spectrum

This review aims to synthesize recent evidence and accounts evaluating the utility of blue light cystoscopy (BLC) across the disease spectrum of bladder cancer, including its diagnostic, surveillance, and post-treatment uses, as well as its outpatient applications, economic impact, patient perspectives, and future directions. While initial studies on BLC suggested an advantage over traditional cystoscopy in terms of diagnostic power and recurrence rates for non-muscle invasive bladder cancer, recent studies are more equivocal on its benefits and suggest that the utilization of blue-light cystoscopy is more nuanced. Evidence is lacking on a clear superiority of blue light for all bladder cancer patients. Cost, logistics, and accuracy concerns indicate certain patients may benefit from this procedure more than others. BLC can be a valuable adjunct to white light cystoscopy in the management of bladder cancer. It provides high diagnostic sensitivity but there are questions surrounding its cost-effectiveness, positive predictive value, and its role in effective surveillance and reduction of tumor recurrence require further longitudinal and standardized investigation.