{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T13:12:30Z","timestamp":1761743550824,"version":"build-2065373602"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003246","name":"Nederlandse Organisatie voor Wetenschappelijk Onderzoek","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To study the effect of renally cleared fluorescent agents on image\u2010guided surgery along the urinary tract by using the renally cleared, non\u2010tumour\u2010specific, fluorescent dye fluorescein.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>Sixteen patients who underwent robot\u2010assisted radical prostatectomy (RARP) with lymph node dissection received an intradermal injection of fluorescein. The slow\u2010release of the fluorescein from the\u00a0skin into the lymph\u2010 and bloodstream were used as a pharmacokinetic\u00a0model for slow release from receptor\u2010targeted agents. The presence of fluorescein in the urine and the surgical dissection planes around the prostate (representative of cancer margins) during RARP were evaluated. Suction, gauze and irrigation were used to try and reduce fluorescent background signals according to standard operating protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fluorescein was detected in the urine in the bedside catheter bag after a median of 1.3\u2009h after agent administration and in the surgical field after opening the bladder neck as part of RARP (median of 2.4\u2009h after injection). Suction and application of gauze helped to reduce contamination, but suction combined with irrigation with lukewarm NaCl 0.9% was shown to be most effective. Fluorescein accumulation was seen in the tissue surrounding the bladder neck in 80% of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Renally excreted fluorescent agents risk contamination of the surgical field and possible dissection margins along the urinary tract, a feature that, without proper counter measures, could compromise the accuracy of intra\u2010operative imaging by creating false\u2010positive findings. A clear example of this was the observed bladder neck staining with fluorescein.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16804","type":"journal-article","created":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T11:34:55Z","timestamp":1752406495000},"page":"515-522","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Renal clearance of fluorescent agents can compromise image\u2010guided surgery along the urinary tract"],"prefix":"10.1111","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3328-384X","authenticated-orcid":false,"given":"Anne\u2010Claire","family":"Berrens","sequence":"first","affiliation":[{"name":"Department of Urology Netherlands Cancer Institute \u2013 Antoni van Leeuwenhoek Hospital  Amsterdam The Netherlands"},{"name":"Department of Urology Amsterdam University Medical Center, Location VUmc  Amsterdam The Netherlands"},{"name":"Interventional Molecular 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