Bladder tumor antigen, nuclear matrix protein 22, telomerase activity, fibrin degradation products assay, and a number of diagnostic tests on exfoliated urethelial cells are being tried to replace or decrease the frequency of cystoscopies. The results of these studies have shown that although some of these tests are promising, the standard of care for patients with hematuria or previously treated bladder carcinoma is still cystoscopy. New and non-invasive tests are on the horizon, however. It is essential to find accurate prognostic factors in patients with T1 disease which will predict the cases which will progress to muscle invasive disease. It has been clearly shown that the depth of invasion within the submucosa is closely related with survival. It has been established that continent diversions improve the quality of life in patients who have undergone cystectomy. Furthermore, this type of diversion was shown to improve survival. This fact can be attributed to early cystectomy which was prompted by the increased patient acceptance.