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The high recurrence rate of urothelial cancer as well as its challenging detection especially of aggressive tumors such as carcinoma in situ still represents one of the main challenges in bladder cancer diagnosis and treatment. To overcome this burden, different technologies have been studied and established. One of the most successfull technologies regarding the direct diagnosis of tumouros lesions represents the Photodynamic Diagnosis (PDD). PDD is nowadays well establisehd during TUR-BT and has proven a positive impact on different diagnostic levels as well as on early and late recurrence rates. However, if we want to use PDD also in an outpatient setting, there is the clear demand for a sufficient flexible approach which guarantees patients´ comfort and a low morbidity. Unfortunately the use of flexible PDD has shown several drawbacks in the past as the diagnostic accuracy seemed not to be high enough and comparable to rigid cystoscopy.
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