The use of three chip high definition camera with modular enhancement system with white light cystoscopy during transurethral resection of bladder tumours. Does it improve carcinoma in situ detection?

: The goal of our study is to assess if the use of Storz professional image enhancement system (SPIES) improve carcinoma in situ (CIS) detection. We conducted a prospective study on 35 patients of both sexes who have fulfilled the inclusion criteria from December 2019 to May 2020. Preoperatively, we collected urine samples from all patients amenable for cystoscopy for urine analysis and urine cytology. Contrast enhanced abdomen and pelvic computerized tomography (CT) was done for all patients. Under spinal anaesthesia white light cystoscopy (WLC) was done first, then SPIES camera was used by the same operator to detect any other suspicious lesions. TURBT was done for all lesions and specimens were sent for histopathology assessment. Our results showed that there was statistically significant difference between the SPIES and WLC regarding the number of lesions detected, as the total number of lesions detected by the SPIES was 37 lesions, three of these lesions were CIS, but the WLC detected only 27 lesions, no CIS was detected by WLC ( p value 0.001). Pathological recurrence was confirmed in 6/35 (17.1%) patients at 3 months follow up.