This will be a prospective trial comparing the perspective gross morphological of bladder tumor assessment done by outpatient flexible cystoscopy performed by resident, inpatient rigid cystoscopy done by senior staff and their prediction of the degree of invasion of bladder tumor plus the prediction of the grade compared with the standard pathological result.

Also, assessment of the patient reported outcomes after both flexible and rigid cystoscopy will be done.

In the long run of the study, the prognostic gross morphology with recurrence, progression and cancer specific survival will be assessed.

Inclusion Criteria:

• Men and women 18 years or older
• Denovo or recurrent NMIBC
• Bladder mass discovered in hematuria investigation
• Willing to share in study

Exclusion Criteria:

• inability to cooperate with flexible cystoscopic evaluations
• cystoscopies for other kind of intervention (e.g., removal of a ureteral stent)
• Untreated infections
• Other causes of storage or voiding symptoms as untreated benign prostatic hyperplasia (BPH) or interstitial cystitis
• Unpassable urethral stricture

All patients diagnosed with suspected denovo, recurrent bladder mass or hematuria needing assessment by flexible cystoscopy will be asked to participate in this study at Urology and Nephrology Center Outpatient Clinics and will be provided with an informed consent form in line with Good Clinical Practise and the Declaration of Helsinki.

meta-analyses by contact the Prof. Hassan Abol-Enein, MD, Phd (Study Chair)