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Abstract Bladder cancer is the seventh most commonly diagnosed cancer in the male population worldwide, while it drops to eleventh when both genders are considered.(1) It represents a major healthcare problem especially in Egypt .(2) Approximately 75% of patients with bladder cancer present with a disease confined to the mucosa (stage Ta, CIS) or submucosa (stage T1).(3) Cigarette smoking, occupational exposures to carcinogens, and chronic infection with Schistosoma haematobium have been established as risk factors for bladder cancer.(4) The most common presenting symptom of bladder cancer is painless hematuria, which occurs in about 85% of patients. Also the symptom complex of bladder irritability and urinary frequency, urgency, and dysuria is the second most common presentation of bladder cancer and is usually associated with diffuse CIS or invasive bladder cancer.(3) Transurethral resection of bladder tumor (TURBT) has been yet the gold standard for the treatment of non-muscle invasive bladder cancer (NMIBC).(3) However, the main disadvantages of TURBT include thermal damage of the adjacent tissue and piecemeal resection of the tumor, followed by the risk of recurrence and difficulties in accurate pathological evaluation of the tumor stage. (5) It has been proven that the presence of detrusor muscle is crucial for the quality and completeness of resection. While the absence of detrusor muscle in the specimen is associated with a significantly high risk of residual disease, tumor understaging, and early recurrence. (6). |