The aim is to evaluate the intraoperative, postoperative and pathologic findings of early second look TURBT and the factors affecting these findings to assess the value of early second TURBT in the management of high risk NMIBC.

Inclusion Criteria:

• patients underwent initial complete resection TURBT with high risk non muscle invasive bladder cancer including: High grade T1 Any carcinoma in situ Any recurrent high grade Ta High grade Ta tumor size is more than 3 cm Any BCG failure in high grade patient Any variant histology Lymphovascular invasion High grade prostatic urethral involvement

Exclusion Criteria:

• - Low risk non muscle invasive bladder cancer
• intermediate risk non muscle invasive bladder cancer
• muscle invasive bladder cancer
• metastatic bladder cancer (positive lymph nodes or distant metastasis )
• absent muscle layer in the initial TURBT biopsies
• incomplete resection initial TURBT

patients who underwent initial complete transurethral resection of bladder tumor with high risk non muscle invasive bladder cancer, recruited from the urology outpatient clinic, Urology department, Ain shams University.