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Intraoperative Visualization Agents

Visualization agents — fluorescent dyes, visible dyes, and photosensitizers — enable intraoperative tissue identification, perfusion assessment, lymphatic mapping, tumor detection, and fistula / leak localization in urology and urogynecology. Indocyanine green (ICG) is the dominant agent and has transformed robotic urologic surgery through integration with near-infrared (NIR) fluorescence platforms (Firefly, SPY, PINPOINT, Rubina).[1][2] This article is the clinical-application hub — procedures and evidence by indication. For agent-level pharmacology, dosing, and imaging-hardware compatibility, see the dedicated pharmacology pages:

For imaging hardware, see Robotics platforms.

Agent quick-reference​

AgentClassDetectionExcretionPrimary urologic role
ICGTricarbocyanine NIR fluorophoreNIR camera (Firefly / SPY)HepaticPerfusion, SLN mapping, renal tumor ID, ureter adventitial mapping[3]
Methylene bluePhenothiazine visible dyeWhite light ± NIRRenalUreteral ID, fistula localization[4]
Indigo carmineVisible dyeWhite lightRenalCystoscopic ureteral-efflux aid; BLUDIGO approved in 2022[38]
Sodium fluoresceinVisible / UV dyeWhite light / cobalt-blueRenal (rapid)Ureteral jet visualization post-indigo-carmine era[6][7]
Pudexacianinium (ASP-5354)Renally-excreted ICG derivative, NIRNIR cameraRenalInvestigational IV ureteral visualization[8][9]
Hexaminolevulinate (Cysview)PDD photosensitizerBlue-light cystoscopeN/ABladder-cancer detection[10][11]
5-ALAPDD photosensitizerBlue-light cystoscopeN/ABladder-cancer detection (oral or intravesical)[12]
Oral phenazopyridineAzo dye (non-fluorescent)White-light cystoscopeRenalOff-label ureteral jet aid; favorable in a historical cost model[13]
Rizedisben (Illuminare-1)Myelin-binding fluorophoreBlue-light camera—Investigational nerve-specific imaging[14]

Robot-assisted partial nephrectomy (RAPN) — ICG's flagship urologic application​

Meta-analytic evidence​

Giulioni 2023 meta-analysis (8 comparative studies, n = 535; predominantly observational evidence):[15]

  • ICG-guided RAPN — lower warm ischemia time (WMD −2.05 min; p = 0.011)
  • Better postoperative eGFR preservation (WMD +7.67 mL/min; p = 0.002)
  • No statistically demonstrated difference in positive surgical margin rates or tumor recurrence; these comparisons do not establish equivalence

Diana 2020 TRoNeS multi-institutional series (n = 318): trifecta 79.9% and MIC 71.7%. There was no control group, so these results cannot establish that ICG improved outcomes. Imaging may aid strategy in difficult vascular anatomy.[3]

Three distinct intraoperative functions​

FunctionTechniqueEvidence
Tumor identificationMalignant renal tumors are typically hypofluorescent (dark) against brightly fluorescent normal parenchyma; benign tumors range from iso- to hyperfluorescentTobis 2011 — 7/10 malignant tumors hypofluorescent; 3 isofluorescent[16][17]
Selective arterial clampingICG injection after selective clamp confirms ischemic zone; enables superselective ischemia preserving uninvolved parenchymaHarke 2014 matched-pair — eGFR loss 5.1 vs 16.1 mL/min selective vs global (p = 0.045)[18]
Endophytic tumor markingPreoperative superselective transarterial ICG-lipiodol embolization tags totally endophytic masses for intraoperative NIRF identificationSimone 2019 and Nardis 2022 — 63.4% well-defined margins + 34.1% blurred margins; 100% technical success[19][20]

Sentinel lymph node (SLN) mapping​

Penile cancer — strongest SLN evidence​

EAU/ASCO guidance, current 2026 chapter, recommends surgical staging for high-risk cN0 disease (T1b or higher), preferably DSNB at an experienced center. ICG is an adjunct in hybrid-tracer workflows; it does not replace the radiotracer, pathological examination or the full staging pathway.[21]

  • Dell'Oglio 2020 n = 400 patients / 740 groins — hybrid ICG-⁹⁹ᵐTc-nanocolloid localized all pre-op-defined SNs; fluorescence detected 96% of all excised SNs and yielded a 39% higher detection rate than blue dye (p < 0.001)[22]
  • Zhang 2023 meta-analysis — ICG-NIR for SLN metastasis in penile cancer: 100% pooled sensitivity; specificity 2%. This very low specificity emphasizes that fluorescence marks lymphatic drainage rather than proving metastasis[23]

Prostate cancer​

  • Manny 2014 (n = 50) — percutaneous robotic-guided ICG injection identified SLNs in 76% with 100% sensitivity and NPV for nodal metastasis[24]
  • Li 2026 (n = 34) — cystoscopic ICG injection — fluorescence detection 97.1%, 100% per-patient sensitivity and NPV, but per-node sensitivity only 66.7%. No metastatic nodes occurred in the low/intermediate-risk subgroup, so its 100% NPV does not establish superior performance there. All participants also underwent extended pelvic lymph-node dissection[25]
  • Wu 2019 meta-analysis (17 studies, n = 1,059 pelvic malignancies) — pooled detection rate 95% (95% CI 93–97); pooled sensitivity 86% (75–94); no ICG-related complications reported. This mixed-cancer evidence should not be generalized as permission to omit indicated prostate-cancer staging[26]

Radical prostatectomy — tissue marking​

ICG injected into the prostate provides tissue marking that differentiates prostate from surrounding structures (NVB, seminal vesicles, vas deferens, obturator nerve) at mean 10 min post-injection. Complementary to NeuroSAFE frozen-section nerve-sparing guidance — not a replacement.[24][27]

Ureteral identification and patency​

The 2014 indigo-carmine shortage prompted studies of alternatives. BLUDIGO now has a US label for adult cystoscopic ureteral assessment, so permanent-unavailability language is obsolete.[38] Dye efflux establishes urine passage at that time; it does not exclude all partial or delayed thermal/ischemic injuries. AUGS supports cystoscopy at pelvic reconstructive surgery; select the aid according to patient factors and availability.[5]

Imaging approaches during robotic or laparoscopic pelvic surgery​

AgentTechniqueDetectionTime to jetCost
Sodium fluorescein0.25–1.0 mL of 10% solution IVWhite-light cystoscope~5 min[7]Moderate
Methylene blueOff-label protocols; see agent hub for systemic precautionsVisible light or a compatible fluorescence system, depending on methodVariable[4][28]Local acquisition cost
ICG (intraureteral / stent-coated)Not by IV for intraluminal visualization — ICG is hepatically cleared; requires direct instillation or ureteral-stent coatingNIR (Firefly)Immediate on instillationModerate
Pudexacianinium (investigational)IV, renally excretedNIRDose-dependent; 100% success at 3 mg in Phase 2[9]Investigational

Oral agent​

Phenazopyridine 200 mg PO preop — orange urine aids ureteral-jet visualization under white-light cystoscopy. A phenazopyridine-first strategy was least costly in the Askew 2022 decision model (mean total modeled cost $110/patient), not a current universal price or guideline recommendation.[13] A 12-patient nonrandomized cohort found mean excretion times of ~82 versus ~5 minutes; this is not a guarantee of onset in every patient.[7] Check renal contraindications in the phenazopyridine hub.

Bladder-distension alternative​

Mannitol bladder distension — Grimes 2017 RCT reported highest overall surgeon satisfaction for ureteral patency assessment; does not require any IV agent.[30]

RCT guidance​

Espaillat-Rijo 2016 RCT (n = 176) — sodium fluorescein and 10% dextrose significantly improved visibility and surgeon satisfaction vs saline; this was not evidence establishing phenazopyridine non-inferiority.[31]

AUGS Consensus 2018 — acknowledges the indigo-carmine shortage, reviews sodium fluorescein and phenazopyridine as defensible alternatives, and supports cystoscopic assessment at pelvic reconstructive surgery.[5]

Methylene-blue ureteral identification during open / MIS surgery​

de'Angelis 2023 WSES IUTI guideline cites a systematic review finding 89.2% of ureters (91/102) identified with IV methylene blue (0.25–1.0 mg/kg, 40 min preop). Advantages: IV administration, no cystoscopy or stenting required. Key caveats: contraindicated in G6PD deficiency and with SSRI/MAOI (serotonin syndrome risk).[4]

Pudexacianinium — investigational ureteral imaging​

ICG derivative engineered for renal excretion, emitting NIR at 820 nm when excited at 780 nm — enables retroperitoneal ureteral visualization through overlying peritoneum via standard NIRF camera.[8] Albert 2023 Phase 2 RCT (n = 12 colorectal) — dose-dependent success: 2/3 at 0.3 mg, 5/6 at 1.0 mg, 3/3 at 3.0 mg; one grade 1 proteinuria AE.[9] The current agent hub records phase III development and 2026 renal pharmacokinetic evidence. No US approval was identified; injury reduction and universal camera compatibility are not established. Molecular imaging reviews describe the broader tracer-development context.[29]

Fistula localization​

Methylene blue remains the standard agent for vesicovaginal / ureterovaginal fistula localization — dilute MB instilled into the bladder reveals vaginal leakage on a tampon or pad. The three-swab (or double-dye) test is a classic clinical-exam adjunct combining intravesical methylene blue with oral phenazopyridine to distinguish VVF from UVF. Detailed in the clinical Vesicovaginal fistula literature.

ICG has been used in select fistula cases where NIR platforms are available, particularly for vesicouterine / uterocutaneous fistula mapping during robotic repair.

Bladder cancer detection — photodynamic diagnosis (PDD)​

Hexaminolevulinate (Cysview) and 5-aminolevulinic acid (5-ALA) are photosensitizing prodrugs — not visualization dyes in the traditional sense — enabling blue-light cystoscopy (BLC) for enhanced bladder-cancer detection.

Mechanism​

After intravesical instillation (hexaminolevulinate) or oral administration (5-ALA), the prodrug enters mucosal cells and is converted to protoporphyrin IX (PpIX), which accumulates preferentially in neoplastic cells due to altered enzymatic activity. Under blue light (360–450 nm), tumor tissue fluoresces bright red against a dark blue normal urothelial background.[10][11]

Hexaminolevulinate (Cysview) — FDA-approved​

  • June 2026 CYSVIEW label: 100 mg in the supplied diluent to 50 mL, retained 1–3 hours before evacuation. Use white-light assessment and an authorized blue-light imaging system. Gross hematuria was removed as a contraindication, although blood can interfere with visualization[10]
  • Kamat 2016 reviews bladder-cancer diagnosis and treatment, including the role of enhanced visualization[32]
  • Maisch 2026 Cochrane update (17 RCTs, 4,890 participants; search through March 2026) — blue-light TURBT may reduce recurrence and progression depending on baseline risk; absolute benefit is greater at higher risk. Most evidence remains low certainty, and a mortality benefit is not established[33]

5-ALA​

  • Inoue 2012 — 5-ALA fluorescence cystoscopy detected 72.1% of flat lesions (dysplasia / CIS) missed by conventional endoscopy; no statistically significant route difference in this retrospective study, which does not establish formal equivalence[12]
  • Ishikawa 2026 region-specific analysis — oral 5-ALA performance varies by bladder region[34]

Guideline position​

EAU 2026 recommends mapping biopsies or PDD-guided biopsies for positive cytology with normal-looking bladder mucosa and normal upper-tract imaging. Also exclude an upper-tract tumor and, when relevant, prostatic urethral disease. PDD alone is not the entire evaluation.[35]

Limitations​

False-positive fluorescence can occur with inflammation, recent TURBT, or BCG therapy. Limited tissue-penetration depth.[33]

Emerging applications​

Rizedisben (Illuminare-1) — nerve-specific imaging​

Novel small-molecule fluorophore that binds myelin and fluoresces at 370–425 nm to enhance nerve visualization. Gold 2025 non-randomized clinical trial evaluated rizedisben during MIS including prostatectomy — feasibility for intraoperative identification of neurovascular bundles and obturator nerves, structures critical for functional outcomes after radical prostatectomy.[14] This phase I, 38-patient study establishes early feasibility, not improved continence or erectile function.

Ureteral reconstruction and perfusion assessment​

ICG can supplement assessment of anastomotic perfusion during robotic ureteral reimplantation and reconstruction; fluorescence does not prove durable viability. Cacciamani 2020 expert consensus systematic review covers technique and safety in detail.[27]

Pediatric urology​

ICG-NIRF has been applied in pediatric partial nephrectomy (duplex systems, tumors), lymphatic-sparing varicocele repair, and oncologic procedures. Published pediatric series describe feasibility, but small observational reports cannot rule out rare serious hypersensitivity.[36]

Safety — the comparative profile​

AgentAdverse-event profileCritical contraindications
ICGAnaphylaxis, including fatal reactionsICG hypersensitivity; current label does not make shellfish or nonspecific iodine allergy a blanket contraindication[37]
Methylene blueHemolysis; boxed serotonin-syndrome warningG6PD deficiency and severe thiazine hypersensitivity; avoid serotonergic-drug/opioid interactions[39]
Indigo carmine / BLUDIGOSerious cardiovascular reactions, anaphylaxis and oximetry interferenceDrug/component hypersensitivity; not recommended eGFR <30 (a precaution, not the formal contraindication)[38]
Sodium fluoresceinTransient skin/scleral yellowing; rare anaphylaxisKnown hypersensitivity
PudexacianiniumSmall early trials cannot exclude rare harms; renal exposure rises in CKDInvestigational
CYSVIEWFalse fluorescence; hypersensitivityPorphyria; hypersensitivity to aminolevulinic acids or product components. Oral 5-ALA has separate jurisdiction/product precautions[10]

Evidence Summary​

ApplicationEvidence levelKey source
RAPN perfusion / ischemiaComparative-study meta-analysis; largely observationalGiulioni 2023[15]; Diana 2020 TRoNeS[3]
Selective clampingLevel 2 (matched-pair)Harke 2014[18]
Endophytic tumor taggingLevel 3Simone 2019[19]; Nardis 2022[20]
Penile-cancer SLNGuideline-supported DSNB; ICG adjunct studiesEAU/ASCO 2026[21]; Dell'Oglio 2020[22]; Zhang 2023[23]
Prostate-cancer SLNLevel 2–3Manny 2014[24]; Li 2026[25]; Wu 2019 meta[26]
Ureteral-patency post-indigo-carmineLevel 1 (multiple RCTs)Espaillat-Rijo 2016[31]; Grimes 2017[30]; Askew 2022 CEA[13]
Methylene-blue ureteral IDLevel 2 (SR; WSES guideline)de'Angelis 2023[4]
PudexacianiniumSmall phase II dose-ranging studyAlbert 2023[9]; Fushiki 2023 preclinical[8]
Bladder-cancer BLCCochrane RCT synthesis; mostly low certaintyKamat 2016[32]; Maisch 2026 Cochrane[33]; EAU 2026[35]
Rizedisben nerve imagingLevel 3 (non-randomized trial)Gold 2025[14]

Clinical Positioning​

  • Perfusion: ICG can inform intraoperative assessment; comparative observational data do not justify promising improved outcomes or mandating routine use for every RAPN.[3][15][27]
  • Lymphatic mapping: use established tumor-specific staging pathways. ICG fluorescence is not a pathology result and does not justify omitting indicated nodal surgery.[21][22]
  • Ureteral assessment: BLUDIGO is currently labeled; fluorescein, phenazopyridine and methylene-blue approaches require their own safety review. Historical cost models do not establish a universal first-line agent.[13][38]
  • New agents: pudexacianinium and rizedisben remain investigational; feasibility and good visualization are different from improved patient outcomes.[9][14]
  • Blue-light cystoscopy: use the current CYSVIEW label and bladder-cancer guidelines. The 2026 Cochrane update supports possible risk-dependent benefit with important uncertainty.[10][33][35]
  • Drug safety: ICG hypersensitivity, methylene-blue interactions/G6PD deficiency and BLUDIGO cardiovascular reactions require distinct checks. See the individual drug hubs for dosing and monitoring.[37][38][39]

See Also​

References​

1. Licari LC, Bologna E, Proietti F, et al. "Exploring the applications of indocyanine green in robot-assisted urological surgery: a comprehensive review of fluorescence-guided techniques." Sensors. 2023;23(12):5497. doi:10.3390/s23125497

2. Fransvea P, Miccini M, Rondelli F, et al. "A green lantern for the surgeon: a review on the use of indocyanine green (ICG) in minimally invasive surgery." J Clin Med. 2024;13(16):4895. doi:10.3390/jcm13164895

3. Diana P, Buffi NM, Lughezzani G, et al. "The role of intraoperative indocyanine green in robot-assisted partial nephrectomy: results from a large, multi-institutional series." Eur Urol. 2020;78(5):743–749. doi:10.1016/j.eururo.2020.05.040

4. de'Angelis N, Schena CA, Marchegiani F, et al. "2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery." World J Emerg Surg. 2023;18(1):45. doi:10.1186/s13017-023-00513-8

5. Cohen SA, Carberry CL, Smilen SW. "American Urogynecologic Society consensus statement: cystoscopy at the time of prolapse repair." Female Pelvic Med Reconstr Surg. 2018;24(4):258–259. doi:10.1097/SPV.0000000000000529

6. Doyle PJ, Lipetskaia L, Duecy E, Buchsbaum G, Wood RW. "Sodium fluorescein use during intraoperative cystoscopy." Obstet Gynecol. 2015;125(3):548–550. doi:10.1097/AOG.0000000000000675

7. Cohen SA, Chaudhry Z, Oliver JL, et al. "Comparison of times to ureteral efflux after administration of sodium fluorescein and phenazopyridine." J Urol. 2017;197(2):519–523. doi:10.1016/j.juro.2016.07.099

8. Fushiki H, Yoshikawa T, Matsuda T, Sato T, Suwa A. "Preclinical development and validation of ASP5354: a near-infrared fluorescent agent for intraoperative ureter visualization." Mol Imaging Biol. 2023;25(1):74–84. doi:10.1007/s11307-021-01613-0

9. Albert M, Delgado-Herrera L, Paruch J, et al. "Pudexacianinium (ASP5354) chloride for ureter visualization in participants undergoing laparoscopic minimally invasive colorectal surgery." Surg Endosc. 2023;37(9):7336–7347. doi:10.1007/s00464-023-10193-9

10. CYSVIEW. US prescribing information, revised June 2026. DailyMed.

11. Casas A. "Clinical uses of 5-aminolevulinic acid in photodynamic treatment and photodetection of cancer: a review." Cancer Lett. 2020;490:165–173. doi:10.1016/j.canlet.2020.06.008

12. Inoue K, Fukuhara H, Shimamoto T, et al. "Comparison between intravesical and oral administration of 5-aminolevulinic acid in the clinical benefit of photodynamic diagnosis for non-muscle-invasive bladder cancer." Cancer. 2012;118(4):1062–1074. doi:10.1002/cncr.26378

13. Askew AL, Myers ER, Dieter AA. "Cost-effectiveness of agents used for evaluation of ureteral patency during intraoperative cystoscopy in gynecologic and urogynecologic surgery." Am J Obstet Gynecol. 2022;226(1):100.e1–100.e6. doi:10.1016/j.ajog.2021.08.055

14. Gold SA, Pere MM, Assel M, et al. "Rizedisben in minimally invasive surgery." JAMA Surg. 2025;160(8):875–883. doi:10.1001/jamasurg.2025.1987

15. Giulioni C, Mulawkar PM, Castellani D, et al. "Near-infrared fluorescence imaging with indocyanine green for robot-assisted partial nephrectomy: a systematic review and meta-analysis." Cancers. 2023;15(23):5560. doi:10.3390/cancers15235560

16. Tobis S, Knopf J, Silvers C, et al. "Near-infrared fluorescence imaging with robotic-assisted laparoscopic partial nephrectomy: initial clinical experience for renal cortical tumors." J Urol. 2011;186(1):47–52. doi:10.1016/j.juro.2011.02.2701

17. Tobis S, Knopf JK, Silvers C, et al. "Robot-assisted and laparoscopic partial nephrectomy with near-infrared fluorescence imaging." J Endourol. 2012;26(7):797–802. doi:10.1089/end.2011.0604

18. Harke N, Schoen G, Schiefelbein F, Heinrich E. "Selective clamping under the usage of near-infrared fluorescence imaging with indocyanine green in robot-assisted partial nephrectomy: a single-surgeon matched-pair study." World J Urol. 2014;32(5):1259–1265. doi:10.1007/s00345-013-1202-4

19. Simone G, Tuderti G, Anceschi U, et al. "'Ride the green light': indocyanine green-marked off-clamp robotic partial nephrectomy for totally endophytic renal masses." Eur Urol. 2019;75(6):1008–1014. doi:10.1016/j.eururo.2018.09.015

20. Nardis PG, Cipollari S, Lucatelli P, et al. "Cone-beam CT-guided transarterial tagging of endophytic renal tumors with indocyanine green for robot-assisted partial nephrectomy." J Vasc Interv Radiol. 2022;33(8):934–941. doi:10.1016/j.jvir.2022.04.016

21. EAU/ASCO. Penile Cancer Guidelines, 2026: diagnostic evaluation and staging. Current chapter.

22. Dell'Oglio P, de Vries HM, Mazzone E, et al. "Hybrid indocyanine green–⁹⁹ᵐTc-nanocolloid for single-photon emission computed tomography and combined radio- and fluorescence-guided sentinel node biopsy in penile cancer: results of 740 inguinal basins assessed at a single institution." Eur Urol. 2020;78(6):865–872. doi:10.1016/j.eururo.2020.09.007

23. Zhang R, Zhang Y, Dong S, et al. "Performance of indocyanine green in sentinel lymph node mapping and lymph node metastasis in penile cancer: systematic review, meta-analysis, and single-center experience." World J Urol. 2023;41(9):2319–2326. doi:10.1007/s00345-023-04485-x

24. Manny TB, Patel M, Hemal AK. "Fluorescence-enhanced robotic radical prostatectomy using real-time lymphangiography and tissue marking with percutaneous injection of unconjugated indocyanine green: the initial clinical experience in 50 patients." Eur Urol. 2014;65(6):1162–1168. doi:10.1016/j.eururo.2013.11.017

25. Li YH, Chuang YF, Ou YC, et al. "Cystoscopic ICG-guided sentinel lymph node dissection in robotic radical prostatectomy: a prospective study." Prostate. 2026. doi:10.1002/pros.70107

26. Wu Y, Jing J, Wang J, et al. "Robotic-assisted sentinel lymph node mapping with indocyanine green in pelvic malignancies: a systematic review and meta-analysis." Front Oncol. 2019;9:585. doi:10.3389/fonc.2019.00585

27. Cacciamani GE, Shakir A, Tafuri A, et al. "Best practices in near-infrared fluorescence imaging with indocyanine green (NIRF/ICG)-guided robotic urologic surgery: a systematic review-based expert consensus." World J Urol. 2020;38(4):883–896. doi:10.1007/s00345-019-02870-z

28. Cwalinski T, Polom W, Marano L, et al. "Methylene blue — current knowledge, fluorescent properties, and its future use." J Clin Med. 2020;9(11):E3538. doi:10.3390/jcm9113538

29. Hernot S, van Manen L, Debie P, Mieog JSD, Vahrmeijer AL. "Latest developments in molecular tracers for fluorescence image-guided cancer surgery." Lancet Oncol. 2019;20(7):e354–e367. doi:10.1016/S1470-2045(19)30317-1

30. Grimes CL, Patankar S, Ryntz T, et al. "Evaluating ureteral patency in the post-indigo-carmine era: a randomized controlled trial." Am J Obstet Gynecol. 2017;217(5):601.e1–601.e10. doi:10.1016/j.ajog.2017.07.012

31. Espaillat-Rijo L, Siff L, Alas AN, et al. "Intraoperative cystoscopic evaluation of ureteral patency: a randomized controlled trial." Obstet Gynecol. 2016;128(6):1378–1383. doi:10.1097/AOG.0000000000001750

32. Kamat AM, Hahn NM, Efstathiou JA, et al. "Bladder cancer." Lancet. 2016;388(10061):2796–2810. doi:10.1016/S0140-6736(16)30512-8

33. Maisch P, Hamidi Madani M, Koziarz A, Narayan VM, Kim MH, Dahm P. Blue versus white light for transurethral resection of non-muscle invasive bladder cancer. Cochrane Database Syst Rev. 2026;6:CD013776. doi:10.1002/14651858.CD013776.pub3.

34. Ishikawa Y, Tanaka H, Kobayashi M, et al. "Bladder region-specific analysis of the diagnostic performance of oral 5-aminolevulinic acid fluorescence cystoscopy in non-muscle-invasive bladder cancer." Jpn J Clin Oncol. 2026;hyaf171. doi:10.1093/jjco/hyaf171

35. EAU. Non-muscle-invasive bladder cancer guidelines, 2026: diagnosis. Current chapter.

36. Esposito C, Borgogni R, Autorino G, et al. "Applications of indocyanine green-guided near-infrared fluorescence imaging in pediatric minimally invasive urologic surgery: a narrative review." J Laparoendosc Adv Surg Tech A. 2022;32(12):1280–1287. doi:10.1089/lap.2022.0231

37. IC-GREEN. US prescribing information, revised January 2026. DailyMed.

38. BLUDIGO. US prescribing information, revised November 2025. DailyMed.

39. PROVAYBLUE. US prescribing information, revised February 2024. DailyMed.