• Hematuria gross or microscopic present in 85% of cases. Degree of bleed not proportional to stage of disease. Demonstration of disease requires an evaluation. Classically IV urogram and cystoscopy.
• Irritative voiding symptoms. Occurs in 20% of patients, especially carcinoma in situ. Part of the differential diagnosis for interstitial cystitis.
• Incidental finding on imaging
• Incidental finding on cystoscopy

References

• Droller MJ: Bladder: Anatomical overview in surgical management of urologic disease: An anatomic approach, MJ Droller, St. Louis, Mosby Yearbook, p 575, 1992.
• Herr HW, Schwalb DM, Zhang ZF, et al: Intravesical bacillus Calmette-Guerin therapy prevents tumor progression and death from superficial bladder cancer: Ten-year follow-up of a prospective randomized trial. J Clin Oncol 13:1404, 1995.
• Lamm DL: Complications of bacillus Calmette-Guerin immunotherapy. Urol Clin North Am 19:565, 1992.
• Malkowicz SB: Superficial bladder cancer: The role of molecular markers in the treatment of high-risk superficial disease. Semin Urol Oncol 15:169-178, 1997.
• Messing EM, Catalona W: Urothelial tumors of the urinary tract. In: Campbell's Urology 7th ed. PC Walsh, AB ED Vaughan, AJ Wein, Vol 3, Chap 77, 2327, 1998.
• Spruck CH, Ohneseit PE, Gonzalez-Zulueta M, et al: Two molecular pathways to transitional cell carcinoma of the bladder. Cancer Res 54:784-788, 1994.

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